It’s important to prepare yourself and your family to take your baby to the emergency room (ER) even if you don’t know when that emergency will happen. Preemies and other NICU babies going home may have diagnosed medical problems such as hydrocephalus from brain bleeds at birth, tracheostomy or feeding tubes, or the need for corrective surgery. They also face higher rates of respiratory illnesses and hospitalization even in the absence of any medical conditions. Whether your baby is medically complex or easy breezy, you can prepare yourself, your child, and your family to take them to the emergency room before the emergency occurs. Here are some tips from my experiences as a parent and an emergency nurse.
1. Take a First Aid Course
Preemie and other NICU parents are often encouraged to take an infant and/or child CPR course before taking their baby home. A basic first aid course empowers you with the knowledge you need to manage minor injuries in the home and to keep calm during an emergency. Keep a stocked first aid kit at home and in the car. Smaller travel kits can fit into a diaper bag.
2. Play Doctor
Since the first weeks of their lives are full of painful procedures, babies that have spent time in the NICU may be wary of a medical environment or even to being touched. You can give your child the tender home life you always hoped for whilst helping them desensitize to simple medical interventions. Measure a temperature under your child’s arm during play time with a real or pretend thermometer. Use a toy stethoscope to listen to your child’s breathing. When your child is older, engage in imaginary role play. Take turns being the doctor and the patient. When you take your preemie to the emergency room for real, the process may seem less intimidating. If you child needs medical equipment, allow the child to explore it to become familiar and comfortable (as appropriate to his or her age), such as wearing the face mask of a nebulizer or handling syringes for feeding tubes. Of course, you need to supervise the use of all medical equipment. No small pieces should be left near children who put objects in their mouth, even if you are close by.
3. Keep Your Child’s Medical Information on Hand
Your discharge summary from the NICU should include important diagnoses your child received in the unit, as well as any ongoing concerns upon going home. If you don’t have a discharge summary from your hospital, ask your family physician to help you prepare one. You can also create one by yourself if you feel comfortable. Keep this summary with your child’s health information (insurance or identification). Carry a copy with you in case you unexpectedly take your baby to the emergency room. Not all hospitals and clinics manage pediatrics and/or complicated children. It may be helpful to check before you go.
4. Have an Emergency Bag Ready Before the Emergency
Whether you have a complicated child or a child without ongoing problems, it is super helpful to have a goodie bag of toys and distraction tools ready to grab and go in the event that you take them to the emergency room. Not all clinics provide child friendly distractions. Items to put in your bag include toys with cleanable surfaces, crayons and a colouring book (or paper), diapers/wipes as required, a book for reading, and snacks. Check first with medical staff if your child can eat. Avoid snacks with allergens when possible.
5. Take a Deep Breath
No one can manage an emergency situation with a panicked mind. Take a deep breath and remain calm before you do anything. Consider whether or not your child needs an ambulance versus taking them to the emergency room in a car. If your child is blue or not breathing or not waking up, you need an ambulance. With most concerns that would make you take your baby to the emergency room, you still have enough time to make sure your child has adequate clothes and footwear. I’ve looked after several toddlers whose parents swooped them to the nearby hospital without winter clothes or shoes! If you remain calm, you’ll be able to think straight about what you need to bring, drive safer, and answer questions more coherently when you arrive.