Most sick days are not emergencies, and a few are. This guide sorts the symptoms we hear about most into three groups: call 911, go to the emergency department, or call us. If you cannot tell which group your child is in, call (541) 555-0148. That number works at any hour. After 5:30 pm, on weekends and on holidays it reaches one of our own pediatric providers on call, not a call center.
Call 911 now if your child
- is struggling to breathe: the skin between the ribs pulls in with each breath, they are grunting, or they are too breathless to talk or cry
- has blue or gray lips or skin
- is unresponsive, limp, or very hard to wake
- has a seizure that lasts longer than five minutes
- has swelling of the lips or tongue with trouble breathing after a food, sting or medicine. Use an epinephrine auto-injector first if you have one
- has bleeding that does not slow with firm pressure, or a serious injury such as a fall from a height or a car crash
Go to the emergency department today
These need an exam, and often a test or an X-ray, within hours. They do not usually need an ambulance. The emergency department at St. Charles Bend is open around the clock.
- A baby under 3 months with a temperature of 100.4°F (38°C) or higher. Call us first, day or night, and we will tell you where to go. Do not give fever medicine before you call.
- Signs of dehydration: no pee in 8 hours, no tears when crying, a very dry mouth, or a sunken soft spot in a baby.
- Fever with a stiff neck, a severe headache, or a rash of small purple or dark red spots that do not fade when you press a clear glass against them.
- A head injury followed by vomiting more than once, confusion, a headache that keeps getting worse, or sleepiness that is not normal for them.
- A possible broken bone: an arm or leg that looks bent, or a child who will not put weight on a leg or use an arm.
- A swallowed button battery or magnet, even if your child seems fine. These can burn through tissue within hours.
- Sudden, severe pain in the testicles, or belly pain that settles low on the right and gets worse with walking or jumping.
If your child swallowed a medicine or a chemical and has no symptoms, call Poison Control first at 1-800-222-1222. They answer 24 hours a day and will tell you whether your child needs to be seen.
What about urgent care?
Urgent care clinics treat plenty of minor injuries well. Many are set up mainly for adults, though, so call ahead for a young child. For any baby under 3 months, go to the emergency department.
Call us the same day
We hold same-day sick appointments open every weekday morning, and Saturday mornings are for sick visits by appointment. Call when we open at 8:00 am for the best choice of times. These are the symptoms that belong here:
- A fever that has lasted more than 24 hours in a child under 2, or more than 3 days in a child 2 or older
- Ear pain, a sore throat with fever, or pain when peeing
- Wheezing that gets better with a rescue inhaler but keeps coming back
- Vomiting or diarrhea in a child who is still drinking and still peeing
- A rash with a fever, as long as the spots fade when pressed
- Pink, crusty eyes, or a cough that is getting worse after a week
- A cut that gapes open. Stitches work best within a few hours, so call and we will tell you whether to come here or go elsewhere
Our same-day sick visits are with whichever provider has a morning slot free, and they send a note to your child’s own provider the same day.
Usually fine to watch at home
- A cold with a runny nose and a mild cough, in a child who is eating, drinking and playing between naps
- Vomiting once or twice, followed by keeping small sips down
- A fever in a child over 3 months who perks up when the fever comes down
That last point is worth holding onto. How your child looks and acts an hour after a dose of fever medicine tells you more than the number on the thermometer. A child who is playing again is reassuring, whatever the reading was. Our guide to fever in babies and children covers the numbers in more detail.
What helps when you call
Have these ready and the call will be quicker, whether it is with our front desk or the provider on call:
- Your child’s temperature, how you took it, and when the fever started
- Their rough weight, which we need for any medicine dose
- Any medicine you have given, with the time of the last dose
- How many wet diapers or trips to the bathroom today
- Any long-term condition, such as asthma or a heart problem
- The name of your pharmacy
You will never be made to feel you called for nothing. Parents know their children, and “something is not right” is a perfectly good reason to pick up the phone.
Sources
- American Academy of Pediatrics, HealthyChildren.org: Fever: when to call the pediatrician
- American Academy of Pediatrics, HealthyChildren.org: When your child needs emergency medical services
- National Capital Poison Center: Button battery ingestion
- Health Resources and Services Administration: Poison Help line
