Pediatric emergency care

In children, fever is usually the sign of a harmless viral infection and very rarely (about 1 in 100) indicates a severe illness. However, there are times when a fever warrants immediate medical attention. You should bring your child to the ER for a fever if they:

• Are less than three months old and have a temperature of 100.4°F or higher
• Are immunocompromised
• Have concerning symptoms (lethargy, unexplained rash, repeated vomiting or diarrhea, severe stomach pain)
• Are an older child with a fever 102°F or above and doesn't respond to medication or lasts for more than three days or one that consistently spikes to 103°F or higher

Unless it's a really obvious break, it's often hard to diagnose a fractured bone without an X-ray and a medical exam. Children who exhibit any of the following symptoms may have a fractured or broken bone and should be seen right away. Seek immediate treatment if your child:

• Has intense pain or pain that lasts longer than a few days after a fall or injury
• Has numbness and tingling
• Has swelling, bruising, or bleeding
• Is not using or is favoring the non-injured limb
• Is too young to talk and keeps pointing to a body part or cries when it is moved or touched
• Is unable to walk or is walking crooked

Stomach pain is among the top reasons for ER visits for both adults and children. More correctly termed abdominal pain, it has a long list of potential causes — from benign (too much candy or fried food) to life-threatening (appendicitis). It's often hard to know when to "tough it out" and when to seek treatment. For children, especially infants and babies too young to tell you what's wrong, you should seek immediate treatment if your child has stomach pain, that is:

• Accompanied by a high fever
• Accompanied by other serious or unusual symptoms, such as difficulty breathing or change in their behavior
• Accompanied by repeated vomiting (babies younger than three months who are vomiting or having diarrhea should be seen right away)
• Localized to one particular area (e.g., the lower right quadrant could indicate appendicitis)
  
• Prolonged, lasting 24 hours or more
• Severe (infants and babies are inconsolable)
  

If your child is having trouble breathing, call 911.

Breathing problems can have huge impacts and need to be taken seriously. Emergency medical technicians (EMTs) can start emergency breathing treatment on the way to the hospital. These symptoms could indicate asthma or a serious respiratory infection:

• Barking noise that accompanies a cough
• Bluish, purplish or grayish skin, especially around the lips, inside the mouth and around the fingernails
• Breathing fast, shortness of breath or shallow breathing
• Can't breathe through nose and mouth
• Coughing that lasts more than three weeks
• Having an asthma attack
• Unresponsiveness, incoherence, confusion, agitation or dizziness
• Wheezing or raspy breathing

Please remember that you know your child better than anyone. Sometimes you just know something is wrong. Even if your child's symptoms fall outside of the guidelines, listen to your parental intuition if you think immediate medical care is necessary.