What to do in paediatric emergencies

We’re prepared to bet that your family has its own collection of health horror stories: that time when Gavin ran through a plate glass window; the beach holiday where the allergic cousin got stung by jellyfish; how everyone had food poisoning after an East Coast seafood dinner. If and when children’s medical emergencies happen, you’d best be prepared, says Children’s Clinic paediatrician DR HENG SIOK KHENG. “The more prepared you are, the better you can handle them when they arise. You may even be able to prevent them from occurring in the first place.”

What sorts of children’s medical emergencies do you see in your practice?

Broadly speaking, paediatric emergencies are either traumatic or medical.

I recently treated a five-month-old baby after a fall off a bed – her parents’ bed. She had a huge swelling at the right side of her head. Emergency scans indicated a small bleed in the brain, from which, thankfully, she recovered uneventfully. As many parents will have discovered, it’s dangerous to put a baby on an adult bed, as they have an amazing capacity to flip over in the blink of an eye.

One of the most rewarding outpatient situations to treat is a pulled elbow, which occurs when one of the bones in the lower arm slips out of its normal position at the elbow joint, causing pain that makes the child unable to lift the arm at the elbow. Thankfully, we can generally ease the pain by manipulating the elbow joint.

One day, a year-old toddler was brought to me in this condition. Immediately after manipulation, he was able to lift his left arm high above his head and give us a big smile. The joy and relief on his mother’s face was priceless!

Can you give an example of a medical emergency?

A seizure, usually brought on by fever, can be a frightening experience – not just for the child, but for the caregiver. I recall the day a frantic, sobbing mother came into my consultation room, carrying her unconscious two-year-old in her arms. The girl’s limbs were jerking and her eyes were rolled back.

Following medication, the seizure subsided, but Mum was definitely traumatised. So, while it is all right to let a child go through a natural course of an illness and “fight” a fever, one should be aware of this possible complication and also know how to deal with it. Any advice for parents on keeping their children safe? As the old adage goes, prevention is better than cure. We frequently see injured schoolchildren, and I feel that a lot of classroom or schoolyard injuries could be avoided by teaching children how to avoid endangering themselves or others. For example, being careless with newly sharpened pencils can cause eye injuries, and being hit by a racquet, a ball, a hockey stick and so on can cause a lot of damage.

What’s the good news, then?

Caregivers who know the risks and how to minimise them need not fear any unforeseen emergencies that may arise. Fortunately, Singapore ambulances respond promptly, and hospital emergency services are well equipped to handle all kinds of problems 24 hours a day.

Children’s Clinic
Block 177 Toa Payoh Central, #01-160
kidsclinic.sg | 6354 0662

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This article first appeared in the December 2017 edition of Expat Living. You can purchase a copy or subscribe so you never miss an issue!