A look at pediatric emergency cases

Most pediatric emergency cases can be avoided if only parents and yayas find the time to learn basic safety rules in childcare. But more often than not, the safety rules are disregarded either through lack of education or sheer carelessness.

These were the very words of Dr. Rhea Cabrera-Ribaya, head of St. Luke’s Medical Center Pediatric Emergency Medicine Unit, an integral part of the hospital’s ER.

The section, with nine rotating doctors specializing in various specialties such as pediatric emergency medicine, neonatology, ambulatory pediatrics and pediatric cardiology, was created earlier this year to address the increasing number of pediatric cases brought to ER.

"Nothing can be more heart-rending than to see a worried mother holding on to a convulsing child, a crying toddler who was bitten by a dog or cases of infants that had bruises due to falls from a certain height like the parents’ bed or the stairs," said Ribaya whose section treats an average of 1,000 young patients monthly.

Most cases brought to the ER range from infectious diseases like high fever with colds and cough, diarrhea and pneumonia (whether viral or bacterial) to others like falls, accidental ingestion of poisonous substances or objects, dog bites (all year-round), burns and scalds and drowning.

A big portion of the pediatric emergency doctor’s job is anticipatory guidance with emphasis on safety. Parents and household help are advised to take stock of all objects and substances like cleaning agents that might harm the child. The medicine cabinet should be out of reach of the child and all bottles properly labeled.

Caution is also given as to the use of walkers or "andadors" which Ribaya pointed out are a major cause in falls. She noted that in the United States mobile walkers have been banned unlike in the Philippines where they are still very much in use. Proper supervision is needed on the part of the parent or yaya. For pet lovers, be sure that the animals have been properly immunized.

Panic is the worst enemy of parents or any member of the household looking after a sick child. If the child has high fever, giving sponge baths (ordinary tap water will do) round the clock will help bring down the temperature. Avoid the sudden drop in temperature caused by putting ice or putting the child under the shower to have a rapid cooling effect. Applying alcohol to the body is a big no. If there is vomiting, turn his head to one side so as to prevent backflow which might choke the child. As to seizures that normally last from three to five minutes, never put any object like a spoon in the mouth. Once the seizures stop, bring the child right away to the hospital.

There has been scientific evidence that children chronically exposed to smokers in the house suffer from chest infections and are also prone to catching ear infections. Parents can help a lot in preventing secondary smoke get into their children’s lungs.

With the opening of classes and the start of the rainy season, certain precautionary measures are recommended to avoid sickness and prevent accidents. Children, especially those living in flood-prone areas, should be prevented from playing outdoors so as not to catch colds and fever but also leptospirosis, the dreaded disease caused by rats’ urine. There is also the growing concern on the increasing number of drowning victims, examples of which include kids falling in manholes and getting caught in swift currents.

Here is what Ribaya often says, "Most accidents and diseases affecting children can be prevented if we just take the time to learn how to prevent them. The use of one’s common sense is the best guide in child care."

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For more information, call St. Luke’s Medical Center’s Corporate Communication Department at 723-0101 locals 4214 and 4216. Dr. Rhea Cabrera-Ribaya graduated cum laude in BS Psychology from the University of the Philippines, got her medical degree from the University of the East, had her residency at Beth Israel Medical Center, New York and was a fellow for Pediatric Emergency Medicine at the Albert Einstein College of Medicine-Montefiore Medical Center in New York.