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It's a common dilemma when your child seems sick: Do you call the doctor, make a trip to urgent care or head straight to the emergency room?
If it's not an emergency, a call to your child's pediatrician may help guide you. The doctor's staff may recommend bringing your child in for a visit or going to urgent care -- particularly after hours when the pediatrician's office isn't open.
Children's Hospital of Los Angeles (CHLA) offers the following guidelines:
Call the doctor or go to urgent care if your child has a fever that has lasted more than three days.
Above all, trust your instincts.
"I tell parents, if you know in your heart that your child has to go to the ED, just go," pediatrician Dr. Christopher Tolcher said in a CHLA news release. He's with Agoura-West Valley Pediatrics, part of the CHLA Health Network.
CHLA recommends calling the doctor or going to urgent care for COVID-19 symptoms such as fever, runny nose and dry cough; for injuries such as sprains, strains or swelling; for minor cuts that need stitches; and for minor burns that need treatment.
A doctor call or urgent care is another good choice if your child has stomach issues such as diarrhea, nausea or vomiting; appears to have a bladder infection; has a cough, sore throat, sinus pain or earache; or has skin problems or a rash.
When is it an emergency?
Head straight to the emergency room if your child has a severe injury or illness that seems like it could be life-threatening or needs immediate treatment.
The emergency department is also a good choice for a child who is unusually tired or sleepy or is acting differently from usual; is in severe, persistent pain; has trouble breathing, or is breathing fast or deep. A broken bone or an injury that looks like the body part is deformed or out of alignment, possibly with numbness or a lot of swelling, also calls for an ER visit, CHLA advised.
An ED visit is also needed if there's bleeding from a large or deep cut, a large cut to the head, chest or abdomen, or bleeding that will not stop after placing pressure for 10 minutes. Other reasons for an ER visit: a head injury causing vomiting, headache, confusion or loss of consciousness; or a fall from a significant height.
Call the Poison Control Center if your child is acting OK but has had too much medicine or the wrong medicine. The center can be reached at 1-800-222-1222. If that has happened, and your child has trouble breathing, collapses or can't wake up after being poisoned, call 911.
Call your doctor, but then also head to the emergency department if your infant is younger than 2 months old and has a fever of 100.4 or higher, CHLA recommends.
Also go to the ED if your child has a high fever in combination with a stiff neck and headache; a fever with a widespread purple-red rash; or is very dehydrated (dry diapers, eyes that look sunken and the child not peeing, especially after vomiting or diarrhea). With dehydration, the child can also seem very weak.
Call 911 when your child is choking, is not breathing, has lips turning an unnatural color, has a seizure for the first time or a seizure lasting longer than five minutes. Also call if your child is not responsive or appears to have passed out.
Other reasons to call 911: an injury to the neck or spine, severe head injury, severe burns such as from a fire or burns near the eyes, nose, mouth or groin, and for a severe allergic reaction with swelling and trouble breathing.
If you're just not sure what you should do and it's not an obvious emergency, call your doctor. Most offices have an after-hours line.
The American Academy of Pediatrics has more on what to do when your child needs emergency medical services.
SOURCE: Children's Hospital Los Angeles, news release, Nov. 17, 2022
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