Do not delay rushing your child to the nearest reliable hospital in an emergency.
What Is An Emergency Situation?
Your doctor will usually advise you on this; but in the
absence of a doctor, if you feel that your child’s condition
has suddenly taken a turn for the worse, act on your instincts and
take her to a hospital immediately. An experienced relative or a neighbour may also be able to
help you take an
appropriate decision in such a situation.
The decision to admit a child to a public or private
hospital should depend on the urgency and seriousness of the
situation, the accessibility of the hospital, the facilities
available and the cost of treatment. If a public hospital is nearer your
home and the child looks serious, do not hesitate to take the
child there. This is especially true in cases of accidental injuries
where the police are involved. You can shift the child later to
another hospital, if required. If the hospital has a casualty
department, go directly over there. The Casualty may be indicated in a local
language like ‘Apghat
Vibhag’ (in
Hindi). If you cannot find it, go directly to the children’s ward.
If you are travelling and need medical care in a remote
area, in a village or a small town, go to the nearest
Government Primary Health Centre.
Talking To Your Child About Hospitalisation
If your child is older than 3 years, it is best to
explain to her why you have decided to take her to the hospital. She
should never ever get the impression that she is being
hospitalised because she was naughty or careless.
Visiting The Hospital In Advance
If it is not an emergency admission, you and your spouse
may like to visit the hospital to meet the doctor and
nursing staff; to find out about the facilities available and also to
get an idea about the expenses involved.
The Hospital Stay
In India, the mother, or any other relative close to the
child, is allowed to stay with her in the hospital. Besides, you
can get a pass for a visitor.
At the time of admission, you may be asked to fill a
consent form to permit any investigation or operation. Read it carefully before you sign.
Secure in Dad’s arms in the intensive care unit
If the child is too sick, she may be sent straight to an intensive care unit. You are usually not
allowed to stay
with the child in such a set-up. But if you feel that she
will do better with you by her side, discuss it with your doctor
who may give special permission for you or someone else to
be with the child. Since you will have to sit up all the
time in intensive care, have someone take turns with you.
Daily Routine In The Hospital
A friend once said of hospital that it is a place where
they wake you up to give you your sleeping pills. Indeed, in
most hospitals, there is a time for a sponge bath, for
recording temperature and pulse, and for taking medicine. If this schedule disturbs your young child,
discuss it with your doctor and the sister-in-charge of the ward and together
work out a routine that is convenient for your child and yet
does not unduly upset the hospital routine.
For example, if your child had a disturbed night and
went to sleep in the early hours of the morning, request the
nurse on duty to avoid giving her the sponge bath at the usual
time. If the nurses are too busy to do this later, take on the responsibility yourself.
Avoid crowding the bedside with visitors, except during
the visiting hours.
Also remember that nurses are human too. Ignore an occasional shortcoming if the nursing
staff and the rest
of the hospital staff are cooperative on the whole. If someone
is persistently rude, however, do inform your doctor to do the needful.
Keep Yourself Informed
You have a right to know what drugs your child is
getting. If a drug is to be given at a fured time, see that the nurses give it accordingly. A few minutes’ delay may
be over-looked. Take permission to give the medicine
yourself, if you prefer this.
Similarly, keep an eye on the intravenous fluids being given. If your child is right-handed, let
the
intravenous drip be started in the left hand. Find out at what rate the
fluid should run (drops per minute). If the flow changes suddenly,
report it to the nurse. Inform the nurse when a small amount of
fluid is left in the bottle, so that she can stop it in time or
get another bottle ready, if need be.
In short, keep an eye on the treatment being given to
your child. Mistakes can happen because of lack of
communication, and the child may be given a medicine that the doctor
had ordered to be stopped. Therefore, do not leave
everything in the hands of the hospital staff. Trust them, but do not
hesitate to politely point out any mistake that you may notice in
the management of your child.
Also let the doctor know if your child is allergic to
any particular drug. Indicate it prominently on her case
papers. Inform the staff if your child has G-6-PD deficiency.
Children with this problem can have serious reactions to certain
drugs.
The doctor may prescribe a certain diet for the child.
If there are no such restrictions, discuss with the
hospital dietitian what your child would prefer. You need the
doctor’s and hospital’s permission to have food brought from
home.
Investigations
Children older than 3 should be briefed about the tests
that may have to be conducted. If you are apprehensive about blood collection for testing, leave the room when this
is being done. But if you feel that your child will feel more
secure in your presence, your doctor may allow you to be present. Ask your doctor in advance if there is any need for
fasting before a test. For tests like ECG, ultrasonography, a CT (computed
tomography) scan, MRI (magnetic resonance imaging) or echocardiography, the doctor may decide to
sedate a child under the age of 4 years. Older children
may undergo a procedure without any sedation, if it is
properly explained to them.
Surgery
Do not hesitate to share your fears or economic
difficulties with your doctor when he recommends surgery for your child.
Emergency surgery cannot be delayed, especially in a newborn baby; otherwise, a surgical
procedure may be deferred if the child has a cold, cough, fever; if it is
more convenient to get it done during holidays, after a
wedding, or for some other personal reasons. Some families wrongly assume that surgery should be avoided during the summer
season or in the monsoon.
Inform your doctor if the child has had any problem
earlier with surgery, anaesthesia or a particular drug. Also,
let him know if your child has a bleeding tendency or if she is
on any medication, especially corticosteroids, insulin and
drugs for epilepsy. The doctor would also like to know if your
child has been given corticosteroids in the recent past.
In general, doctors advise that no milk or solids be
given for at least 12 hours prior to giving anaesthesia. Clear
liquids with glucose can be given for upto 4 hours prior to it. Sometimes,
the doctor may give some intravenous fluids through a drip before surgery.
Sedation Before Surgery
Your doctor will probably give your child some
medication before taking her into the operation theatre. The idea
is to let the child go into a light sleep before she is taken away
from you. It also allows for the induction of anaesthesia
without waking her up and also provides some relief from pain
after the child recovers from the effect of anaesthesia.
Observation After Surgery
The surgeon will keep the child in the surgery room
situated near the operation theatre for some time before sending
her to the ward. If your child is less than 6 months old,
she will be kept for about 2 hours to make sure that her
physiological functions, including her breathing and reflexes, are
normal.
In the ward, the child may need medication for pain
relief. Your presence and that of your husband or a close
relative can drastically reduce the need for such medication. Your
touch can act like magic. Do not hesitate to hold your child’s
hand or stroke her cheeks even if she is connected to medical equipment. Whenever possible, hold her in your arms, hug
her and kiss her.
Maintain a cheerful atmosphere around the child. If you
feel like crying, do not suppress your emotions, but avoid
breaking down in front of your child. Your child may appear to
behave very unreasonably, but remember that she is probably
just very frightened. Encourage her to share her anxieties
with you so that you can reassure her.
Teenagers should be taken into confidence about the management of their illness. If your
doctor agrees, your adolescent may be told about her illness, and have the
planned line of management explained to her. You are then likely
to get better cooperation from her during her hospital
stay.
