Published: Sept. 1, 2010
Updated: Sept. 1, 2010
When a child needs medical attention, a parent has to decide where to go for treatment depending on when the child becomes ill, the degree of illness, and the proximity to one of our locations. Luckily, we have many options at Duke.
Duke Children’s Primary Care has an extensive primary care network that can see patients Monday to Friday during the day -- and Saturday morning at our Roxboro Street location.
When our primary care locations are closed, we have Duke Urgent Care clinics open 365 days a year at Brier Creek, Hillandale Road, Morrisville, Knightdale, and Fayetteville Road.
And we have the Duke Emergency Department (ED) and its dedicated Pediatric Center, which is open 24 hours a day, seven days a week.
In general, appointments for colds, chronic diseases, and an occasional ear infection can be scheduled easily within 24 hours at one of our primary care sites. Children with issues in need of immediate care outside of clinic hours can be seen at the urgent care sites. But some children have urgent or emergent issues at unusual hours and may need to be seen in the emergency department.
Dr. James Fox, a Duke pediatric emergency department physician, explains which symptoms indicate a visit to the ED is needed.
-- Dennis Clements MD, PhD, MPH
Unfortunately, every year millions of children in the United States will require emergent medical care for a wide variety of injuries and illnesses. Fortunately for the children living in the Triangle, Duke University Hospital has a specialized area in the emergency department that only treats children.
The multidisciplinary medical team takes great care in providing age and developmentally appropriate treatment to children in the ED. The pediatric ED at Duke cares for children 24 hours a day, every day of the year with direct and immediate access to experts in every pediatric subspecialty should the need arise.
Many children cared for in the pediatric ED do not have life-threatening conditions, and many of the children’s conditions may be cared for by the child’s primary care physician.
However, there are many illness which are best cared for in the pediatric ED. The following are a few examples of conditions that should be treated in the pediatric ED. (This list is not meant to be all-inclusive.)
There are many causes of labored breathing in children. However, if at any time you are concerned about your child’s breathing, he should be evaluated quickly by a physician. Signs of difficulty breathing include:
Here are a few specific considerations in children with trouble breathing:
While the vast majority of children who have a fever do not have a dangerous illness, fever may be a marker of a serious infection (e.g. meningitis, pneumonia, urinary tract infection). Children with fever are often tired, much less active, and less interested in eating and drinking.
Giving your child weight-appropriate doses of acetaminophen (Tylenol) or ibuprofen (Motrin; do not use if your child is less than six months old) may make your child feel better and more interested in eating and drinking.
You should bring your child to the ED for evaluation if your child:
Call 911 immediately if your child has a fever and:
If your child has ingested a toxic chemical (fertilizer, household cleaners, insecticides, oils, etc.) or a medication that was not prescribed to him or taken in an excessive amount (this includes over-the-counter and herbal or “natural” products), he may require an ED evaluation.
If your child is acting normally or you are unsure if he swallowed a potentially poisonous substance, a call to the Poison Center will be helpful (800-222-1222).
Call 911 immediately if your poisoned child:
When children injure bones, parents often wonder when it is necessary to bring their child to the ED for evaluation. Here are some guidelines:
If you believe your child’s injured bone needs to be evaluated in the ED, you may give your child a dose of Tylenol or Motrin but do not allow your child to have anything to eat or drink until he is evaluated by a physician.
-- James Fox, MD, is a physician in the Duke Department of Pediatrics' Division of Hospital and Emergency Medicine.
-- Dennis Clements, MD, PhD, MPH, is the chief of primary care pediatrics at Duke Children's Hospital.