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Part 4: Keeping Your Child Healthy  >  Managing A Hospital Stay

PART 4: KEEPING YOUR CHILD HEALTHY

MANAGING A HOSPITAL STAY

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
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. 




7 March, 2016

 
Part 4
Keeping Your Child Healthy
Choosing A Paediatrician
Proper Use of Medicines
Home Remedies
A First Aid Kit
The A-Z of Childhood Illnesses
Psychological Concerns
Managing A Hospital Stay
Emergencies
Prayer And Your Child's Health
The Role of Nature Cure
Homoeopathy
Ayurveda and Child Care
Congenital Heart Disease FAQ
 
Guide to Child Care
Home
Introduction
1 Pregnancy, Childbirth ...
2 The Growing Years
3 Feeding Infants, ...
4 Keeping Your Child Healthy
5 Keeping Your Child Happy
About Dr. R. K. Anand
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