It can be difficult to know whether a sick or injured child needs an appointment, urgent care, or emergency care. The information below can help you recognize some common warning signs.
This guide cannot cover every situation or replace medical evaluation. If you are concerned about your child and are unsure what to do, please call the office during business hours or use the after-hours triage line when the office is closed.
Call 911 or seek emergency care
Seek emergency medical care for symptoms such as:
- Severe difficulty breathing, struggling to breathe, or blue or gray lips or face
- A seizure, especially a first seizure or one that does not stop
- A child who is very difficult to wake, unresponsive, or unusually limp
- A serious injury, uncontrolled bleeding, or obvious deformity
- A severe allergic reaction involving difficulty breathing, swelling of the tongue or throat, or symptoms involving more than one body system
- A suspected button battery or multiple-magnet ingestion
- A serious head injury with concerning symptoms such as loss of consciousness, repeated vomiting, seizure, confusion, worsening symptoms, or difficulty waking
- Any situation in which you believe your child may be experiencing a medical emergency
Do not wait for a callback from the office or after-hours triage line in an emergency.
Fever
Fever is common in childhood and is usually a sign that the immune system is responding to an infection. In older infants and children, how your child looks, behaves, drinks, urinates, and breathes is often more important than the temperature alone.
Babies younger than 1 month: A rectal temperature of 100.4°F (38°C) or higher requires prompt medical evaluation. Please contact us immediately for guidance, or seek emergency care if you cannot promptly reach a medical professional or your baby appears ill. In this age group, do not use medication to treat the fever.
Children over 1 month: Please call if your child is having signs of dehydration, has trouble breathing, is unusually sleepy or difficult to wake, has significant pain, develops other concerning symptoms, or if you are worried about how your child looks or acts. In general, a child who is urinating at least three times in 24 hours, is breathing comfortably, becomes more comfortable when the fever comes down, and has had a fever for three days or less can usually be monitored at home. Please call if the fever lasts longer than three days, your child is getting worse rather than better, or you are concerned for any reason.
Breathing concerns
Pay attention to how hard your child is working to breathe, not just whether they have a cough or congestion.
Concerning signs can include:
- Skin pulling in between or underneath the ribs or at the base of the neck
- Nostrils flaring with breathing
- Grunting
- Head bobbing in an infant
- Breathing that is unusually fast or labored
- Difficulty speaking, eating, or drinking because of breathing
- Blue or gray lips or face
- A harsh or high-pitched sound when breathing in while resting
Significant difficulty breathing requires emergency evaluation.
If your child has asthma and has an asthma action plan, follow the plan and seek additional care when directed or if your child is not responding as expected to their rescue medication.
Vomiting, diarrhea, and dehydration
When children have vomiting or diarrhea, one of the most important things to watch is whether they are able to stay hydrated.
Signs of dehydration can include:
- Urinating significantly less often than usual
- A dry mouth or tongue
- Few or no tears when crying
- A sunken soft spot in an infant
- Unusual sleepiness or decreased responsiveness
- Inability to keep fluids down
For vomiting, small and frequent amounts of an oral rehydration solution are often better tolerated than larger amounts at once.
Please call if you are concerned that your child is becoming dehydrated or is unable to keep down enough fluid. Seek urgent or emergency care if your child is difficult to wake, unable to drink, has significantly decreased urination, or appears seriously ill.
Head injuries
Most minor bumps to the head do not cause a serious injury, but symptoms after a head injury should be monitored carefully.
Seek prompt medical evaluation for concerning symptoms such as:
- Loss of consciousness
- Repeated vomiting
- A seizure
- Increasing or severe headache
- Confusion or unusual behavior
- Difficulty walking or speaking
- Weakness
- Difficulty waking
- Symptoms that are worsening rather than improving
If you are unsure whether your child needs to be evaluated after a head injury, please call for guidance.
Call the office
Not every illness needs emergency care, but please contact us when you are concerned about symptoms that are persistent, worsening, or interfering with your child's ability to eat, drink, sleep, attend school, or participate in normal activities.
Examples include persistent fever, ear pain, sore throat, prolonged cough, an unexplained or worsening rash, persistent vomiting or diarrhea, a limp or refusal to use an arm or leg, or a child who is eating or drinking significantly less than usual.
If you are simply unsure whether your child needs to be seen, it is also appropriate to call.
What to have ready when you call
When possible, please have:
- Your child's name and date of birth
- A brief description of the concern and when it started
- Your child's temperature and how it was measured, if applicable
- The names, doses, and times of any medications already given
- Your preferred pharmacy
After-hours triage
When the office is closed, an after-hours triage line is available for urgent medical concerns when you are unsure whether your child can safely wait until the office reopens or needs to be evaluated sooner.
The after-hours line is not intended for routine medical questions, prescription refills, scheduling, forms, or other concerns that can wait until regular office hours.
For a medical emergency, call 911 or seek emergency care. Do not wait for a callback from the after-hours triage line.