Avoiding the ER

Familiar risks are the most serious—and the most preventable.

Exotic dangers and rare diseases make for good headlines, but for many kids it’s the everyday, common risks that land them in the ER. In the pediatric emergency department at VCU Health, pediatrician and assistant professor of emergency medicine Dr. Judy Barto likes to take the opportunity not only to provide immediate care but also to educate families about safety and prevention. Barto offers these reminders about common hazards.

Vehicle Accidents

Dr. Judy Barto

“No one ever plans on being in that accident,” says Barto, who regularly sees children injured in car accidents where they were un- or improperly restrained. Every time they get in a car, children should be in a properly installed car or booster seat appropriate to their age, height, and weight. And the safest place for any child under the age of 13—yes, 13 years old—is always in the back seat, says Barto. “We see a lot more injuries with children in the front seat versus in the back seat.”


“The most preventable injury,” Barto says. Of course you should never leave babies and small children alone near water, but older children are at risk of drowning too, often in home and unguarded community pools. “Your child doesn’t need to be an Olympic swimmer,” says Barto, but signing your kids up for some basic swimming and water-safety lessons can help make them safer.

Ingestion of Medicines or Batteries

Barto advises extra vigilance when visiting grandparents to make sure medications are locked up and out of reach of children. “Even an over-the-counter medicine like Tylenol can be very dangerous to children,” says Barto. Tiny button batteries canbe a temptation too. “You always go to the ERwith a button battery,” says Barto.


It’s a by-now familiar refrain of the season: Get the shot. But Barto sees first-hand what a toll this illness can take on kids. Even if nobody in your family has ever come down sick in past years, “Every year is different,” says Barto. “And every year, even healthy children die of the flu.”

Finally, Barto recommends that if you have a choice, taking your child to a hospital with a dedicated pediatric emergency department means you’ll see specialists experienced in caring for children. “Kids aren’t little adults,” says Barto. “We practice a different kind of medicine with them.”

This article originally appeared in our December 2018 issue.

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