Initially, your baby will be examined by a triage nurse who will ask what concern brings you in, check the child's vital signs (heart rate, temperature, respiratory rate, oxygen saturation and blood pressure in older children) and record the child's weight, which is used to determine medication dosages and fluid needs. Because patients are seen in order of severity of illness or injury, this initial exam is very important.

At some point during your visit, a person from registration will get your insurance information. If you do not have insurance, be sure to ask about discount programs that you can apply for that will help cover this visit. At this point, you will also be responsible for a co-pay, which can typically range from $10 to $100. Keep in mind that the co-pay may be reduced (and ER coverage ensured) if you have contacted your doctor prior to coming to the ER.

Once you get into the ER you will be seen by a nurse who will ask for your "story" again, may recheck vital signs and do a brief exam. If necessary, a medical technician may also help attach your child to the monitor (to monitor vital signs), slip an oxygen tube in your child's nostrils and help undress your child.

When the doctor comes in to see your baby, be prepared to tell the "story" again. It can be frustrating to repeat information that a nurse has already recorded, but each caregiver hones in on different details, and the physician needs to get the full picture. You wouldn't want the medical staff playing "telephone" with your child's illness, so include details. Think back to the first time you noted something unusual. For example, maybe the vomiting just started today, but your baby has had fewer wet diapers for two days.

It doesn't take long before kids have doctors figured out. Many start crying as soon as they see my white coat or when I slip on my examining gloves. Even without the poke of a needle, the doctor's visit is rarely a pleasant experience for a child. I recommend holding your child as the physician does the exam, so your baby knows she is safe. You can also help hold down her hands and stabilize her head as the doctor examines her thoroughly.