Important disclaimer: The information on our site is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your Pediatrician.
New Update on COVID-19 please read here: letter-covid-19-for-website.pdf
When to go to the Emergency Room
For true emergencies, call 911.
To activate the office beeper dial 1-808-363-2057 and follow the instructions to enter your phone number. You will receive a call back. If you do not receive a call back in 15 minutes, try again. This number will not receive text messages. The beeper is for true emergencies or urgent situations. Use the text feature for non urgent situations.
As your children’s medical home, we want to make sure you get the right care at the right place. Going to the Emergency Department at the hospital for a strep throat can cost as much as $1500, usually with a very costly co-pay or deductible. The same condition can be treated in our office for less than $100, with your out of pocket cost usually not more than $30.
There are times when you know you have an emergency and the hospital emergency department is the only play to go. The kinds of problems that may need emergency care include:
- Severe and persistent abdominal pain
- Trauma with broken bones or bleeding that will not stop
- Concussions with loss of consciousness
- Difficulty breathing
- Sever drowsiness, difficulty waking up or confusion
- Severe headache
- Stiff neck with fever and headache\Suspected poisoning or drug overdose
- Vomiting that will not stop
- Animal bites
After hours, when the office is closed, we feel an urgent care center is the first choice when your child is ill and needs to be evaluated. Remember a pediatrician is on call when the office is closed to help you decide how to best care for your sick child.
Most pediatric illness is not an emergency and can be seen the next day in the office. If you are not sure, page the pediatrician on call at 1-808-363-2057. This is a digital pager and you must enter the entire number including the area code. If your child is ill, the pediatrician will need to know your child’s name, age, temperature and recent weight, in addition to information about the illness. Our website also has information about common pediatric illness with care plans to help.
Some common scenarios:
Child is running a temperature higher than 103 degrees F. Go to the ER? Rarely
“Fever alone is rarely a reason to go to the ER. The exception is a child that is less than 8 weeks old with any temperature above 100.5 F or more. An older child or toddler with fever can almost always be managed at home. A good indicator of how sick is the child is, wait and see how the child looks when the fever goes down. All children look listless and miserable when the fever is high, but if you can bring the temperature down with medication, sponging and fluids, and your child perks up and looks better, you should be able to continue fever management and see the pediatrician in the morning at the office. Reasons to go to the ER are symptoms associated with the fever, but not the temperature alone.”
Child is vomiting and has diarrhea Go to the ER? Rarely
“This can generally be managed at home. If your child has just vomited, wait at least 20-30 minutes and then offer small sips of clear liquids (saimin broth, miso soup or rehydrating fluids). Do not allow your child to guzzle the liquids, or there is a good chance of more vomiting. Reasons to head to the ER would include vomiting after a head injury; vomiting associated with severe abdominal pain with or without fever; or green vomit which could mean a more serious problem is present. Diarrhea is very rarely a reason to go to the ER: go only if your child has a high fever, refuses to drink, is listless or has bloody stools. Diarrhea usually resolves without treatment as long as hydration is maintained. Do not give fruit juice for diarrhea.” Not sure what to feed or drink? Call the office for advice.
Child is having trouble breathing Go to the ER? Yes
“Actually difficulty breathing is an appropriate trip to the ER; however congestion causing the breathing to be noisy through the nose is not. Severe nasal congestion that makes it hard for your child to sleep is not ‘trouble breathing.’ If your child is struggling, especially if the space between the ribs is sinking in, nostrils are flaring or the skin looks pale or gray, the child needs to be immediately seen.”
Child has a broken limb Go to the ER? Yes
“Broken limbs are a reason to go to the ER. If the pain is severe, or if the limb is not straight, or accompanied by an open wound, that is an appropriate ER visit. If your child falls while playing and then complains of pain, treat first by rest, ice, pain reliever. If your child settles down and is fairly comfortable, he can be seen the following day in the office.”
Child is bleeding due to play Go to the ER? Rarely
“Cuts and lacerations only need to be seen at the ER if the parent cannot control the bleeding, if the wound is deep and requires stitches. Mild wounds can be treated with soap and water, application of an antibiotic ointment and covered with a bandage. Unsure, consult the pediatrician on call for advice.”
Child is bleeding from an animal bite Go to the ER? Rarely
“Animal bites that are not actively bleeding can be seen in the office the next day for possible antibiotic treatment and tetanus vaccine evaluation. Violent animal bites with torn flesh, especially to the face and scalp, should be treated in the ER.”
Child is coughing a lot? Go to the ER? Rarely
“A cough does not need to be seen in the ER unless accompanied by signs of respiratory distress. If you child has a bad cough, but is breathing comfortably between coughs, you can wait until the office opens for evaluation.”
Child has an allergic reaction? Go to the ER? Rarely
“An allergic reaction that involves rashes to the skin should be treated with an antihistamine for itch relief and cool compresses. An ER visit is needed if the reaction includes respiratory symptoms like wheezing, shortness of breath, coughing, swelling of the mouth or tongue, or difficulty breathing.”
Child losses consciousness (faints, trauma, sports etc.) Go to the ER? Yes
“If your child has an episode of unconsciousness after head trauma or injury an ER evaluation is needed. If your child faints but is fine afterward and is otherwise healthy, an evaluation can be completed at the office the following day. If unsure, consult with the pediatrician on call.”
Child ingests a foreign object Go to the ER? Rarely
Unless your child is drooling uncontrollably or having difficulty swallowing, most accidental ingestions just need to be observed. Small watch or camera batteries can be dangerous and imaging might be needed to identify the position and location of the battery.”
Child has a severe headache Go to the ER? Rarely
“Headaches should only be seen if accompanied by persistent vomiting, following head trauma, or if the headache is associated with neurological symptoms like blurred vision. a seizure or weakness in an extremity should be seen in the ER.”