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When to bring your child to the BC Children's Emergency Department

Having a sick child can be stressful, but it helps to know when it’s time to seek emergency treatment.
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The BC Children's Hospital Emergency Department (ED) is experiencing high volumes. 

Emergency departments can be busy and sometimes, to avoid long unnecessary waits, your child’s illness could best be treated at a doctor's office, a walk-in clinic or an urgent primary care centre

Mental health crisis

If your child is thinking about ending their life, get urgent help by calling 9-1-1 or 1-800-SUICIDE. For a mental health crisis, in Vancouver Coastal Health, you can contact the Child and Adolescent Response Team (CART) and in Fraser Health Authority, you can contact The Short Term, Assessment, Response, Treatment (START) Team.

Half of the top reasons patients visit our ED may not actually require a visit to the emergency department.

Emergency versus non-emergency care

Here are some examples to help decide if your child needs emergency care.

Emergency

  • respiratory distress (working hard to breathe or breathing faster than normal)
  • pale skin, whitish or blue lips
  • asthma or wheezing and not responding to prescribed medications
Not an emergency
  • nasal congestion and cough (even if it interrupts sleep)
  • symptoms of the 'common cold'
  • mild asthma or wheezing that responds to usual puffers

Emergency

  • in a child less than 3 months old
  • with immune system problems or complex chronic health problems
  • and very sleepy or difficult to wake
  • for more than 5 days in a child any age
Not an emergency
  • in healthy and vaccinated babies
  • in children who appear generally well

Emergency

  • in a child less than 3 months old
  • repeated vomiting and unable to keep liquids down
  • vomiting or diarrhea containing large amount of blood
  • vomiting bright green
  • dehydration with dry mouth or no urine more than 12 hours
Not an emergency
  • vomiting or diarrhea less than 3-4 times a day
  • ongoing diarrhea after 'stomach flu' (this can last up to 2 weeks)

Emergency

  • head injury with loss of consciousness (passing out) or confusion
  • head injury with visible bump behind the ears, sides of the head, or back of the head
  • head injury with visible swelling and the child is less than 3 months old
  • fall more than 5 feet or 1.5 metres
  • cuts with gaping edges or continuing to bleed despite direct pressure
  • burns that blister and are larger than a Loonie
  • injury to arm or leg that looks crooked, causes inability to use the limb, or creates swelling that does not go down with ice and rest over 48 hours
  • eye injuries
  • injury causing chest or stomach pain
Not an emergency
  • minor head injuries (with no loss of consciousness, no confusion and no vomiting)
  • mild head injuries with normal behavior within 4 hours of injury and bumps (even large) to the forehead
  • scrapes and bruises where the injured part can still be used
  • sun burns

Emergency

  • ‎Fever with a rash that looks like either blisters or bruises that don't turn white or fade when you push on them
Not an emergency
  • recurring rashes or skin problems
  • rashes with cough and cold symptoms, if the child looks well
  • mild hives that respond to antihistamines without difficulty breathing or throat/tongue swelling

‎If your child ingests a chemical, medication or poison, call the poison control centre at 1 (800) 567-8911. 


Come to emergency if directed by them. 

Triage vs. line-up

BC Children’s is committed to ensuring that every child gets the care they need and the most urgent patients are attended to first. 

Our ED triage system, which manages patients based on illness severity, is different than the typical “line-up” some families might expect. In the ED, the most ill patients are seen as a priority.

We thank the patients and families seeking care at BC Children’s for their patience and for being kind and respectful to our staff. 

More on respiratory virus season from our doctor

Respiratory viruses – including colds, flu and COVID-19 – are very common and most young children in daycare or school will experience multiple infections throughout the fall, winter and spring.  It can be frustrating to see them sick every few weeks and it may seem like their cough and runny nose never go away.  

“This is unfortunately common, and while these normal childhood illnesses disappeared during the first few years of COVID-19, this year we are seeing more than usual,” says BC Children’s Division Head of Pediatric Emergency Medicine Dr. Garth Meckler. “Colds and flu make life miserable. Kids – and the whole family – don’t sleep well when congested. Their appetite isn’t good, and they can be fussy or not themselves.”

A cough can last for two to three weeks after a viral infection. Many viral infections also cause fever.  Fever is a sign the body’s immune system is working to fight the infection. Children commonly develop higher fevers than adults with the same infection. Temperatures of 39 to 40 C (or 102.2 to 104 F) are common with viruses like influenza. Fever itself is not dangerous but can make children fussy or sleepy.

No fever-reducing medication

If you are trying to treat a fever without fever-reducing medication, please try these steps:

  • Have your child drink plenty of fluids
  • Dress them in light clothing
  • Sponge them with cool/tepid water

Prevention

There are also things we can all do to help prevent the spread of all respiratory illness this season. These include:

  • Get all recommended vaccines including influenza and COVID-19 booster vaccine doses.
  • Stay at home if you feel unwell and try to avoid spending time with people at higher risk of serious illness.
  • Practice respiratory etiquette: wear a mask in indoor public spaces, cough and sneeze in your elbow.
  • Clean your hands regularly and avoid touching your face, especially your eyes, mouth and nose.

Please note: 

  • The Emergency Department does not have samples or take-home medications such as Tylenol and Advil.
  • The emergency department cannot expedite referrals to specialists
BC Children's Hospital; Emergency; Emergency Department; Emergency room; ED; ER; RSV; enterovirus; rhinovirus; flu; influenza; COVID-19; COVID; Omicron; coronavirus; Respiratory syncytial virus
Children's Health
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