Does my child need to see the doctor? Paediatric Doctor Michael Carter on how to make the call
Being a parent is a tough job; particularly when one of your children is unwell.
But a common difficulty parents have is knowing whether to bring their child to the Emergency Department (ED), visit the GP, or try to manage them at home.
Many children brought to the Emergency Department don't need emergency care. They have ear aches, flus, colds or minor injuries. The majority of these problems can be easily managed by a GP, or even at home.
So, what problems which would prompt at least a GP visit, and likely a trip to the Emergency Department?
Is it just a cold?
A child with a cold may have;
- fever under 39 C for one or two days
- stuffy or runny nose
These symptoms usually last five-to-seven days and if your child is active, playful and eating well, you probably do not need to see a doctor.
Babies under three months are an exceptional group; these children are particularly vulnerable to serious infections and must be treated very cautiously. Always visit a doctor with a baby under three months that has a fever more than 38 C or any child with the following:
- fever that lasts more than a day or two, especially with poor feeding, vomiting, diarrhoea or bad form/irritability
- fever over 39 C
- recurrent fever
The HSE has an excellent website that offers advice about minor ailments and medical issues. It's a great resource for sound and straightforward information about a wide range of common illnesses.
When should I seek help immediately?
Call a doctor straight away if your child shows any of these signs. If you can't reach a doctor, take your child to the emergency department of the nearest hospital immediately. If you are extremely concerned, call an ambulance.
- When a baby under three months has a fever over 38 C.
- Your child develops a rash that does not turn white when pressed upon.
- Unless your child has epilepsy or a known seizure disorder, any seizure should lead you to the ED. If the seizure goes on for more than a couple of minutes, call an ambulance. As Joe Schmidt says, “Be a TEAM player”. There is some excellent information here, including first aid in the event of a seizure.
Always stay with someone who is seizing. Pay attention to how long the seizure is. Stay calm, most seizures last less than five minutes. Move near objects out of the way. Lay the person on their side. Don’t hold the person down. Don’t put anything in the person’s mouth. Check their breathing. Call for help.
- If your child is having trouble breathing they need immediate attention. If there isn’t an Emergency Department nearby, call 112/999.
- If your child is choking on something and is having breathing difficulty or passes out, call 112/999.
- Inappropriate drowsiness or strange behaviour: If you can’t wake up your child, if they seem much more sleepy than usual, are not talking or behaving normally, or if they pass out and won’t wake up, call an ambulance.
- Severe allergic reaction: If your child has a lot of hives or has swelling of the face, and is vomiting, having trouble breathing or becomes wheezy, this could be a sign of a life-threatening allergy. If your child has a known allergy and you have an Adrenaline pen, use it. If not, or if the Adrenaline isn’t helping, call 112/999. Even if the Adrenaline seems to help, you still must go to the ED.
- Vomiting or diarrhoea: Your child may become dehydrated if they can’t keep anything down or have persistent diarrhoea. Signs of dehydration include lethargy, not passing urine for hours/having dry nappies, having a dry mouth, pallor or sunken eyes. Call your doctor if you’re not sure.
The best fluids to use for gastroenteritis are rehydration fluids such as Dioralyte. Whatever fluid you use should contain both sugar and salts. Your child will be low in sugar from poor intake and increased metabolic need. They may be low in salts and water from vomiting and diarrhoea. Avoid using sugar-free or diet beverages such as Diet 7up or Sprite zero, these provide only 'free' water and none of the other required nutrients. This can lead to low blood sugar levels.
Generally, playground falls are not concerning, but any head injury associated with dizziness, vomiting, confusion, impaired walking or talking, drowsiness, or falls from a height could be a sign of a concussion or a more serious injury. Children or teens playing contact sports who sustain a head injury should not re-enter the game.
Burns are common in childhood, and most can be handled at home with advice from your GP. Large burns, blistering burns, white or black burns or burns on the face, hands, private parts or over a joint, need to be assessed in the Emergency Department immediately.
This is far from an exhaustive list and in reality, if a parent’s concern is strong, that is often enough to warrant a GP visit at the least. Follow your parental instincts. If you are thinking about bringing your child to the ED you obviously have a real worry. Don’t trivialise your own concerns and never feel embarrassed about being anxious or seeking help.
Disclaimer: The content of this blog is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Mick Carter is a doctor and a co-founder of the children's book website writingfortiny.com.