Sometimes a kiss, a bandage, and an ice pack aren't enough. The following injuries may require immediate medical attention:

• Head injuries:

  • Bleeding that won't stop after ten minutes of direct pressure.

  • Crying for more than ten minutes after he has hit his head

  • A severe fall (down a stairway, for example)

  • He has a seizure He was unconscious, no matter how briefly

  • He vomits afterward

  • His pupils are unequal in size

  • His eyes are crossed

• Cuts: Very deep or present a “smile” (the skin edges in the center of the cut are farther apart than on the ends)

• Burns: blisters, significantly swells, or has white patches or charring

If you take your child to the emergency room, follow these steps to get the help you need.

• Stay calm. Your child will pick up on your emotions and may become more upset if he sees you panicking. You need to move quickly, deliberately, rationally. Be sure to take your health insurance card with you. Also take your child's lovey, some books to read, and a quiet toy. Unless your child's injuries or illness is life-threatening there is usually a wait to be seen. Organize in your mind the history of the illness/ injury, any pertinent previous illness, and what treatment you've already administered.

• Choose a child-friendly ER if possible. Children's hospitals have pediatric specialists available 24/7. Talk to your doctor before your child ever needs an ER about which hospital to use in an emergency.

• Call your doctor before you go. She can decide if you need to go to an ER, should come into the office, or can treat the problem at home. She can also call ahead to the ER to alert them that you are coming in.

• Be your child's advocate. Speak up and ask to see a doctor immediately if you feel your baby's condition is worsening. Ask questions about diagnosis and treatment and inquire if there are other options if you're not satisfied. Stay with your baby, soothe him in quiet tones.

• Get clear discharge instructions and follow up with your own pediatrician.