fever

When should you take your child to the emergency room? What parents need to know

Jan. 31, 2013 at 9:44 PM ET

When to Take Your Child to the ER
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When to Take Your Child to the ER

In the wee hours of the night, when your baby is running a high fever, it's easy to panic—especially in the middle of a dangerous flu season. Should you rush her to the emergency room?

If you're not sure whether your child needs emergency care, start by calling your pediatrician's office. There may be a doctor on call who can help you make the decision—even in the middle of the night. (Just request to have the doctor paged if a service answers and don't feel badly about it—this is exactly why the doctor is on call.)

If you can't reach your doctor (or while you're waiting to hear back), keep the guidelines below in mind. And remember, if you have any doubts, just head to the ER or call 911—it's better to be on the safe side!

Fever
A fever means your child's body is fighting an infection. The fever itself isn't harmful, but it can make your child feel lousy. So how high is too high? And when should you seek immediate medical attention?

Go to the ER if:Your child runs a temperature over 104 F and has other troubling symptoms, such as trouble breathing, vomiting or inconsolable crying.
Call or see your doctor if
:
—Your child has been running a temperature for more than 5 days. 
—It's been 2 or 3 days, and you're still not sure why your kid has a fever.
—Your baby is less than 3 months old and has a fever of 100.4 F (taken with a rectal thermometer) or higher. If you can't reach your doctor, head to the ER since an infant's immune system isn't fully developed and it's important to get medical help quickly.
—Your child is immune-compromised. Kids who are undergoing chemotherapy, who take immune-suppressing medications and those who have immune system disorders are especially prone to serious infections.
Manage at home if:
—Your child's temp is under 104 F (or under 100.4 for an infant under 3 months).
—It's day 1 or 2 of your child's fever, especially if your child also has a runny nose and mild cough.

Vomiting and Diarrhea
Dozens of things can cause vomiting and diarrhea—luckily, most of them aren't serious. In kids, vomiting and diarrhea are usually caused by a stomach virus that will go away in a couple of days. The real risk is dehydration.
Go to the ER if:
—It's been more than 6 hours since your child last peed or had a wet diaper.
—The soft spot on your baby's head looks sunken in.
—Your child has persistent, uncontrollable vomiting or diarrhea.
—There's blood in the vomit or diarrhea
Call or see your doctor if:
—You're worried that your child isn't taking in enough to compensate for what's going out.
—Your child can't keep down liquids.
—Your child's bottom is becoming sore and red.
—It's been 3 days of vomiting and/or diarrhea.
Manage at home if: Your child is still managing frequent sips of liquid and otherwise looks okay.

Respiratory Distress
Coughs and colds are one thing; struggling to breathe is another.
Go to the ER if:
—Your child is breathing faster than normal. Babies usually breathe 30 to 60 times per minute; toddlers between the ages of 1 and 3 breathe 24 to 40 times per minute and kids ages 3 to 6 breathe 22 to 36 times per minute.
—Your child is really working to breathe. If you see her stomach heaving up and down while she tries to breathe, or the skin sucking in between her ribs, it's time for the ER.
—Your child looks blue or bluish-gray.
—You hear wheezing, grunting or other funny sounds when your child breathes.
—Your child looks listless, or seems panicked.
Call or see your doctor if: The ER doc advises you to schedule a follow-up appointment. If your child has an asthma attack that lands him in the ER, for instance, he might need a follow up appointment to figure out how to better control his asthma.
Manage at home if: Your child has mild congestion that occasionally makes it difficult to breathe. If your child can eat, drink and play normally, he's probably okay.

Bleeding
Most cases of bleeding can be managed at home -- with antibacterial ointment and a superhero bandage.
Go to the ER if:
—The bleeding persists after 15 minutes.
—Your child has a gaping wound.
Call or see your doctor if: Your child has frequent bouts of bleeding (such as frequent nosebleeds).
Manage at home if: It's a typical scrape or cut. Apply pressure if needed; wash with soapy water; dry and apply a bandage. 

A version of this story originally appeared on iVillage.


 

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