As a parent, number one goal is keeping the child safe and healthy. When is the time to head to the emergency department (ED/ER) and when is it best to call the child’s doctor, or go to an urgent care center?

If it's not an emergency, calling your pediatrician or going to urgent care are the best ways to address a variety of medical concerns. Your pediatrician can advise if you should bring your child in for a visit or take them to urgent care—particularly after hours or on the weekend when the pediatrician's office isn't open for visits. Call your doctor or head to urgent care for:

• A fever lasting more than three days

• A fever over 102 for more than two days in an infant—without a clear reason for the fever

• COVID-19 symptoms—including fever, runny nose and dry cough

• Injury such as sprains, strains or swelling

• Minor cuts that need stitches

• Strains and sprains

• Minor burns that need treatment

• Diarrhea, nausea or vomiting

• Bladder infections

• Coughs, colds and sore throats

• Sinus pain and earaches

• Skin problems and rashes

Go to the ED if your child has a severe injury or illness—something that is life-threatening or could cause harm if not treated right away. Head to the ED if your child:

• Is unusually tired or sleepy, or is acting differently than usual

• Is in severe, persistent pain

• Has trouble breathing, or is breathing fast or deep

• Has an injury that seems severe, such as:

  • A broken bone or injury where the body part looks deformed or out of alignment, there is numbness or a lot of swelling, or the child is in severe pain

  • 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

  • A head injury causing vomiting, a headache, confusion or loss of consciousness

  • A fall from a significant height

• Ingests a poison, or too much/the wrong medicine:

  • If your child is acting OK, call the Poison Control Center first: 1-800-222-1222.

  • If your child has trouble breathing, collapses or can’t wake up after being poisoned, call 911.

• Is under 2 months of age with a fever of 100.4 or higher (Call your doctor first.)

• Has a high fever AND a stiff neck and headache

• Has a fever AND a widespread purple-red rash

• Is very dehydrated—diapers are dry, eyes are sunken, child is not peeing—especially after vomiting or diarrhea, or is very weak—can’t move much, drink or talk

Sometimes, there’s no time to call the doctor or even drive to the ED. If it’s a life-threatening emergency, when minutes count, call 911. Examples include: 

• Choking

• Child is not breathing—or lips are turning blue, purple or gray

• Your child has a seizure for the first time, or a seizure lasting longer than 5 minutes

• Child won’t respond, or has passed out

• 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

• Severe allergic reaction, with swelling and trouble breathing

If it’s not a life-threatening emergency and you’re debating between the ED, urgent care or maybe waiting until the morning—pick up the phone and call your doctor. Most offices have an after-hours line or a nurse or doctor on call who can help you decide.

Above all, trust your instinct. “I tell parents, if you know in your heart that your child has to go to the ED, just go,” says Christopher Tolcher, MD, FAAP, a pediatrician with Agoura-West Valley Pediatrics—part of the CHLA Health Network.(KF/Newswise)

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