I had an interesting phone call the other day, while I was having a meeting in a café. I do seem to get a lot of those ‘interesting’ phone calls. My children have learned not to listen. “My 2-year-old son is sitting on the toilet, and he’s straining, and when I went to wipe him, I saw this thing that looks like internal tissue hanging out. Are those his intestines? What should I do?”
Obviously, for any parent, this would be an upsetting afternoon occurrence. We walked through the possibilities together, I told her I didn’t think it could be the intestines, based on the anatomy of the colon, but she should go see the doctor to be sure. He didn’t have fever, severe pain, or apathy. Everything seemed normal, well, except for that.
Eventually, the parents figured out what had happened, more on that in a minute, but this whole discussion made me think, who do we call, what do we do, in those minor emergencies?
I remember distinctly calling up my homeopath in a panic when my two-year-old bit her tongue so hard it left a gash and blood was gushing out of her mouth. “Why did you call me?” she asked. Well, I was thinking, cause I knew you would answer, and I didn’t know what to do. “What should I do?” I asked. “Give her a popsicle. And don’t worry about it.” Mm, hadn’t thought about the popsicle, and we didn’t have to reattach her tongue (okay, I have an active imagination), and life went on. But being a mother, I knew this was not the last time such an incident would occur.
What do we do in an emergency in Israel?
- Know your emergency service supplier in your area, BEFORE the crisis hits. Is it Terem, the moked of the kupah? If it’s after 4 where is the moked lilah? Ask the secretary of your branch office, or look on line to find out where you would need to go.
- When do you go to those emergency services, not ER? I’m not going to go into the obvious details like being knocked unconscious, or obviously fracturing a limb, I’m talking about when you go to wipe your little child’s bum, and see something that doesn’t belong.
- Is the child in pain?
- Does the child have a fever?
- Did something extreme (like a fall) happen recently?
A. If you answered yes to those questions, then it’s reasonable to trot off to your nearest Terem (or moked) for a checkup to rule out more severe issues. Remember, don’t go to the ER for these.
B. If you answered no to those things, meaning the child is playing happily with his siblings, ut has a knot the size of Gibraltar on his forehead [true story], then wait and observe is usually a good idea. Go ahead and make an appointment with your pediatrician/family physician for that day or the next, if possible, and watch for any signs of change. Pain, severe quietness, apathy, fever, etc…go back to A.
- What to do if there’s blood? Remember that the face always bleeds copiously as there is a great deal of capillaries in the area. Before you rush off to Terem (or the kupah night clinic), have the child wash off the wound, and find out where the blood is coming from. If the wound is seeping, edges are far apart, or seems deeper than usual cut, go to moked. If the wound is on the child’s face, call beforehand, because not all moked offices or terem will stitch/glue a wound on the face.
- What to do if this all happens on Shabbat? Well, you could be like us and befriend a surgeon who will operate on your child on a Friday night. However, if you don’t have such an amazing neighbor, then you must make a decision. Wounds need to be stitched/glued within 5-8 hrs of occurrence. This is why you need to know your emergency service after hours clinic before crisis hits.
But we still haven’t answered our original question: To whom do we call?
If it doesn’t meet the Moked or ER criteria (see shirapranskyproject.org for specifics), but you’re still concerned, each kupah has home doctor visit at a subsidized rate.
Maccabi – After hours doctor’s visit – 87 NIS co-pay
Meuhedet – if you need a doctor after hours you can call *6101, bikur rofeh – 140 NIS co-pay
Leumit After hours doctor visit –– 86 NIS
Clalit After hours doctor visit –- – 87 NIS
In addition, Maccabi advertises a 24 hour call service where you can speak to a physician, *3555 and Maccabi kids – *3555 ext. 4 for any child related health problem after hours.
I’ve never used any of these services, although my friend has had ordered Maccabi after hours many times. I’d love to hear your experiences with them.
Oh, and I almost forgot. That strange call I received? Turns out the child had partial rectal prolapse, where a part of the lining of the anus slides down externally, not uncommon in children under age 2. What do you do for it? Push it back in. Simple as that.