Children's Hospital Colorado

How to Keep Your Kids Out of the Emergency Department This Winter

A group of four boys in blue and green snow gear wrestle in the snow.

In the emergency department (ED) at Children’s Hospital Colorado, winter is the busiest time of year. “We do our best to accommodate the volume,” says Mike DiStefano, MD, an emergency medicine specialist at Children’s Colorado.

But emergency departments, Dr. DiStefano explains, care for the most acute patients first — meaning high volumes can lead to long wait times for less urgent cases. The good news is that many times those less urgent cases don’t need to be in the ED in the first place.

Below, Dr. DiStefano outlines the three biggest winter reasons kids end up in the ED — and what parents can do to avoid it.

The cause: influenza

Influenza is unpleasant enough as it is, but one potentially dangerous consequence of it for kids and adults alike is that all those, uh, expelled fluids can result in dehydration. Dr. DiStefano frequently sees kids requiring intravenous rehydration.

“When kids throw up, parents give them a bottle of Powerade or Pedialyte,” says Dr. DiStefano. “And kids are thirsty, so they chug it, and that doesn’t go that well if the intestines aren’t functioning.”

The fix: slow rehydration

Instead of a bunch of water all at once, Dr. DiStefano recommends offering kids a teaspoon or so every three to five minutes. “Then the stomach can absorb it, and the intestines aren’t needed,” he says. He also recommends acetaminophen and ibuprofen to ease fever and aches.

If that approach doesn’t seem to be working, call your child’s pediatrician first. Parents can also address questions to a nurse at Children’s Colorado’s ParentSmart Healthline by calling 720-777-0123 or 855-543-4636, free of charge, 24/7.

The cause: respiratory syncytial virus (RSV)

This common virus produces cold-like symptoms in older children and adults. For a very small minority of kids 2 years old and under, it can also have potentially life-threatening effects.

“It essentially causes mucus production in the lungs,” says Dr. DiStefano. “The smaller the air tubes, the bigger the problem.” In very rare cases, the condition in babies can be severe enough to require a ventilator.

The fix: bringing the fever down

“Sometimes when kids get high fevers, the respiratory system gets taxed,” says Dr. DiStefano. “Getting the fever down can help.” Try a cool washcloth, a fan, cool foods like popsicles, a cool bath, and acetaminophen (be sure to give your child the correct dose for their age and weight). Nasal suctioning, as well as a nasal saline solution, can also be helpful.

What won’t help: over-the-counter cough and cold remedies, as well as products that claim to “break up mucus.” They’re neither particularly effective nor good for babies.

And if your child seems to be having trouble breathing, call 911 right away.

The cause: winter activity accidents

“When we get a big dump of snow, the number of sledding injuries and fractures go up,” says Dr. DiStefano. “I had one day where two separate kids decided to sled off the roof. Both broke bones.”

Lots can happen in the snow. Sledding, skiing and snowboarding can lead to concussions, fractures and sprains. Even heading outside without the right clothing can result in exposure injuries.

The fix: safety, preparation and supervision

Sledding and snow tubing

Sledding injuries can result from collisions with trees, equipment and debris, but just as many result from one person plowing into another. Here are a few tips for finding a safe place:

  • Finding a good hill.Choose one that has a clear path without obstacles in the way. Make sure that the hill does not end on a street, road, parking lot or any bodies of water such as a pond or river. Choose a low-traffic hill (no roofs, please) wherever possible.
  • Never slide down hill headfirst. Sit up facing forward to steer. Risks of head and back injuries are greater by lying down on the sled.
  • Clear the bottom of the hill. Make sure that no one is at the bottom of the hill before allowing another sled to go down the slope.
  • Do not use materials that can be pierced by objects in the ground as sleds. Examples include rubber or plastic sheets.
  • Use a sled with runners and a steering mechanism. Toboggans and snow disks are not as safe.


  • Any child under 6 years of age should not be allowed to ride on a snowmobile, regardless if an adult is present.
  • Children under 16 years of age should not be permitted to operate the snowmobile.
  • A bike helmet is not appropriate. Do wear certified helmets designed specifically for high speed motor sports.

Ice skating

Choose skating rinks over pond skating.

If you do choose pond skating, here are some recommendations:

  • Call local authorities to ask which areas have been approved and to ask permission to skate on a pond or lake.
  • Make sure that the weather has been cold enough for at least one week before skating on a pond or lake.
  • Skates need to be sharpened properly before skating on pond or lake ice.
  • Skiing and Snowboarding
  • If your child has never skied or snowboarded, enroll them in lessons.
  • Warm up the muscles that will be used in skiing and snowboarding with exercise activities to help prevent injuries. Take the time to stretch after the warm up as well.
  • Use proper ski and snowboard equipment such as well fitted boots and adjusted bindings. Ask a certified technician to help with the fittings.
  • Stick to trails within your child’s skill level.
  • Pay attention to signs on the trail. Obey trail closure and do not go off trail.
  • Make sure kids are taking runs within their abilities.
  • If you’re heading to the backcountry, dress kids (very) warmly and check the weather to make sure there’s going to be a way back. Frostbite is real, and it can happen fast.

General safety for any winter activity

  • Always wear a helmet and make sure they are properly fitted.
  • Helmet safety is of utmost importance to help prevent head injuries.
  • Different activities require different types of helmet so choose appropriately and make sure they are certified to meet federal safety standards.

    Activity Type of helmet

    Skiing and snowboarding 

    Ski helmet

    Sledding, snow tubing

    Ski helmet or bicycle helmet

    Ice skating

    Bicycle helmet, multi-sport helmet


    Snowmobile helmet

  • An adult should always be present to supervise
  • Dress for the winter- wear warm fitting clothes, dress in layers and stay dry.
  • Stay hydrated. Have them drink fluid before, during and after their activities.
  • Don’t forget sunscreen. Even on overcast days, especially up in the mountains, the sun rays can be harmful.

*Some of these guidelines are adapted from the American Academy of Orthopaedic Surgeons (AAOS) position statement on winter sports safety.

Still, accidents do happen, and when they do, it’s a good idea to take advantage of urgent care instead of the ED whenever appropriate. Children’s Colorado’s urgent care clinics treat many of the same conditions and injuries as the ED, and the wait times are a lot shorter.

How do you know whether urgent or emergency care is most appropriate? Our guide can help you decide.

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