these are the symptoms of taking your child to the emergency room

The bronchiolitis epidemic is on the rise, despite the implementation of barrier gestures in the context of the Covid-19 epidemic. Faced with this explosion of cases, pediatric emergencies are faced with significant influxes of patients. At the Bordeaux University Hospital, they are close to 200 children who come there daily, compared to the usual 120. According to the French Public Health bulletin of December 1, they are in total 5,098 children under 2 who were seen in the emergency room for bronchiolitis.

Bronchiolitis is a infectious disease which thrives in cold weather, in autumn and winter, with the awakening of RSV (Respiratory Syncytial Virus), and which lasts on average 10 days.
It is a disease that can be serious, especially in infants, because it accelerates the breathing of the child and causes his exhaustion, it is also what contributes to make his symptoms particularly impressive, thus generating a increased worry and a tendency to systematically go through the hospital box. In this period, pediatric emergencies are therefore overwhelmed, and necessarily less able to manage the real critical cases. To help reduce congestion, it is essential to be able to differentiate the symptoms that should alert you, as parents, and lead you straight to the hospital, of those who need a simple city consultation. The pediatric emergency physician known on Instagram as @ to.be.or.not.toubib comes to your rescue to help you sort through your child’s symptoms.

Classic symptoms of bronchiolitis

Bronchiolitis usually starts with a simple cold (stuffy or runny nose) and the child coughs a little. Then the cough becomes more frequent and breathing may become wheezy. The child may be embarrassed to breathe and have difficulty eating and sleeping. He may have a fever. In the majority of cases, bronchiolitis resolves spontaneously after 5 to 10 days but the cough may persist for 2 to 4 weeks after healing.

Symptoms that must lead to emergencies

For parents whose children do not suffer from specific pathologies, the pediatric emergency physician counts in his work Emergencies or not emergencies 4 signals for which you must have increased monitoring.

• Behavior disorder

“A child who is going to be tired, because he is sick, that’s normal, but a child who is amorphous, who is extremely tired, who has trouble interacting with you, who is totally flat, that must make people react”.

• The coloring disorder

“If your child is pale, or their lips and / or extremities turn blue, this is a symptom that should alert you.”.

• Insufficient nutrition

“If the child can no longer eat, it is necessary to react from the moment when he consumes less than 50% of what he would usually eat, in terms of bottles or meals.”.

• Breathing disorder

“Parents should go to the emergency room if the child has breathing problems, that is, if the breathing is very fast and the child is struggling to breathe. We then see its ribs contract, and the areas below the ribs and at the level of the throat widen. This is the most difficult signal to identify, but I usually tell parents that a child who will struggle to breathe will be so badly in terms of his behavior, and he will have so much trouble eating. , that they will necessarily realize, through its overall state, that something is wrong”.

Special cases: infants under 3 months and associated pathologies

For the emergency physician, certain situations require permanent surveillance and great vigilance, as well as a systematic consultation in emergencies. This is the case for infants under 3 months:

For bronchiolitis, I always warn parents that children under 6 weeks should always be routinely examined by a doctor as soon as they have symptoms of bronchiolitis, no matter how severe the symptoms are. Then, between 6 weeks and 3 months, it is strongly recommended.

This is also the case children with associated illnesses, as explained to us @ to.be.or.not.toubib : “Parents whose children have specific pathologies are also concerned: if they have lung or heart problems, they should consult”. Associated diseases can be heart disease, dysplasia, or cystic fibrosis.

What if my child is sick but does not check any of these boxes?

As a parent, there are many reasons that can lead to systematically turning to pediatric emergencies. For @ to.be.or.not.toubib, this is explained in particular by the very impressive character of the expression of a bronchiolitis. He thinks in particular “in the case of children called the ‘happy wheezer’. These are children who will breathe very hard, with wheezing, who will pull a lot, but who will tolerate very well and be very smiley, so parents find it difficult to distinguish between things.. ”

But, to contribute to the proper functioning of hospital services, already overworked in this period of a global pandemic, it is very important to be able to identify classic symptoms and those at risk, both previously mentioned. So, if your child is not less than 3 months old, has no associated disease and does not have any of the 4 risk symptoms identified above, it is not necessary to go to the emergency room.

However, your child remains ill and requires appropriate care for this disease. The emergency doctor sums up the other options available to you to consult :

In this case, the health professionals to be contacted are general practitioners, pediatricians, medical on-call centers often located near hospitals, SOS doctor and, if there is any doubt, the 15th which has a doctor. on call.

Regarding the recent overcrowding of emergencies in the context of the bronchiolitis epidemic, the pediatric emergency physician points out more generally political issues, especially “strong standards of general practitioners”And deplores“a lack of health education”Which would allow parents to better know what attitude to adopt in the event of illness in their child.

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