Parents

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

Sudden health problems are never more frightening than when they involve kids. When a high fever strikes or a deep cut bleeds, should you rush your child to the emergency room?

It can be especially tough to figure out if you’re a first-time parent, but instinct and experience can help guide you what to do next, said NBC News medical contributor Dr. Natalie Azar.

“Once you start to know the pattern of your child and you have more than one child, you get accustomed to things happening. So you should trust your inner voice on your immediate reaction,” Azar said.

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Sudden health problems are never more frightening than when they involve kids.

When in doubt, always call your pediatrician’s office for advice, she noted. You should be able to reach somebody 24/7 — if not your doctor, then a nurse practitioner or a covering physician. Explain what happened and make a decision together about the next steps.

Related: First aid TODAY: Life-saving resources

Here are guidelines to consider for common kids’ health issues:

Respiratory distress

A stuffy nose caused by a cold is one thing, but when your child is really laboring to breathe, that requires immediate attention. “Hands down, that’s the one that is going to be the most urgent,” Azar said.

Call 911 if your child:

— is choking

— struggles to breathe: is flaring his nostrils, breathing very rapidly, or using accessory muscles to breathe, where you can see the skin retract between the ribs. “Those kinds of signs are very worrisome,” Azar said.

— stops breathing

— is turning blue

Contact the doctor if: Your child is breathing with his mouth wide open because he's very congested, but his coloring is good and he's not breathing rapidly.

Treat at home if: Your child has normal congestion from a runny nose or a cold.

RELATED: Is your little one sick? These home remedies will quiet your child's cough in no time

Fever

You know the drill: flushed cheeks, general malaise and a worrisome reading on the thermometer. For most children, it’s less about the absolute number than it is about the accompanying symptoms — unless you have a newborn, Azar noted.

Go to the ER if:

— Your child is under the age of 3 months and her temperature is 100.4° F or higher when taken rectally. There’s a select group of infections that can occur in that age group and because the baby’s immune system is so immature, you can’t assume it’s something her little body can handle on its own, Azar said.

— Your child is older than 3 months and has a fever of 104° F or more, accompanied by symptoms like unresponsiveness, inconsolable crying, trouble breathing, vomiting or seizures.

Contact the doctor if: Your child has had a temperature for several days, but doesn’t seem to have a sore throat, an ear ache or runny nose; and medicine has no effect on the fever.

Treat at home if: It’s only been a few days and your child responds to a fever reducer, like Tylenol. “You give them medicine and then they’re back to normal, then you usually can say to yourself, OK, it’s probably just a bug. Let me ride it out at home, make sure they stay well hydrated,” Azar said.

Bleeding

A sudden fall, trip or cut can happen any time when active kids are running around and exploring their world.

Go to the ER if:

— the bleeding is accompanied by open flesh or exposed bone.

— it’s been 15 minutes since you've bandaged and applied pressure to the area, but the bleeding hasn’t stopped. The wound is probably deep enough that it needs stitches, Azar said.

Contact your doctor if: Your child has frequent bleeds. It could be a platelet disorder or other issues, she noted.

Manage at home if: It’s a small cut or laceration. Clean it out with soap and water and apply a bandage.

Related: Child's stitches, parents' trauma: Natalie Morales survives first E.R. visit

Vomiting and diarrhea

Lots of bugs can cause vomiting and diarrhea in kids. The episodes usually don’t last long, but the concern here is dehydration.

“Once they stop being able to tolerate anything orally, you’re done. You have to get them into the emergency room… and get an IV,” Azar noted.

Go to the ER if:

— your child has had a dry diaper or hasn’t urinated for six hours.

— is unable to keep anything down, even a teaspoon of fluid.

— the soft spot on your baby’s head is noticeably sunken

— your child is crying but not making tears.

— he is listless, not feeling and not looking well

— vomits blood or has diarrhea with blood

Contact your doctor if: The diarrhea keeps returning, or the child is losing weight.

Manage at home if: Your child is able to keep down little sips of fluid, is urinating and producing tears.

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