Nationwide, children four years of age and younger account for nearly 10 percent of all emergency department visits every year. Parents often question when exactly is the right time to take their child to the emergency room when faced with respiratory illnesses and fever, injuries, vomiting and diarrhea. The experts at St. Anthony Regional Hospital in Carroll want to help with these questions and provide some guidelines to follow, especially when the situation is not clear. Sara Roth, St. Anthony Emergency Department Director, says they should follow the consideration of potential emergencies in the same way doctors and nurses do, by thinking ABCD. A is for airway, and if the passage is blocked call 911 and prepare in advance for a choking or similar situation by taking a CPR course. B stands for breathing. Noisy, high-pitched and rapid wheezing or grunting indicates a child is struggling for air. This is frequently seen in an asthma attack or respiratory infection. Get emergency aid if there are more than 60 breaths a minute for an infant, 40 or more for a one year old and 30 or more for an older child. C refers to circulation and applies to more than blood loss from a trauma. Signs like decreased urination, a sunken soft spot on the head, a sticky mouth, tearless crying, sunken eyes with dark circles, listlessness, paleness and clammy skin can all indicate dehydration and the potential need for intravenous fluids. And finally, D stands for disability. Get immediate help for any child who is unconscious or having a seizure. Any child’s first seizure should be treated as an emergency situation to rule out a more serious problem. With a newborn, just about anything out of the ordinary in the first six to 12 weeks is considered as a possible emergency. But ultimately Roth says, the best advice is that when you are in doubt, trust your gut and seek help to navigate through your child’s illness or injury.