As the only doctor in my family or circle of friends, I find myself frequently “on call” for these loved ones. The most common concern, even from the mother of three, is, “Do I need to take her somewhere now or should I wait to see the doctor in the morning?” Most of the time, the answer is – wait until the morning. This is true for most cold-like illnesses, rashes and fevers. There are, however, a few exceptions.
Anytime a child is working hard to breathe, go to the ER if you can’t get in to your doctor right away. A recent text of a friend’s little one with swelling of her lips and difficulty breathing after eating nuts is an example of a time I suggested the ER. Seizures or acute changes in behavior also warrant a trip to the ER, along with severe injuries such as broken bone or deep cut. If your child drank or ate something, like someone else’s medicine, that isn’t food, call the poison control number first (1-800-222-1222), unless the above rules for going to the ER apply.
Fevers and abdominal pain or vomiting can be a little more tricky. Most fevers can wait until a visit to the primary care doctor in the next few days. The most notable exceptions to this are babies under 2 months with any fever, children with poor immune systems such as those who are on or recently finished chemotherapy, and certain children with chronic illnesses like sickle cell. These children need immediate evaluation and a quick call to the pediatrician should help decide where this should happen – in the office or the ER. Children who are over 2-months-old and otherwise healthy, however, can wait. Likewise with abdominal pain, a primary care doctor can evaluate most children within a few days of symptom onset. Abdominal pain becomes more urgent when the child has stabbing pain with fever, is unable to drink or appears dehydrated, or is vomiting up blood or bright green liquid. These warrant more urgent evaluation. A primary care doctor may be able to manage these in office or at least begin an evaluation during office hours, but after hours or if unable to get in to the office, the ER is the place to go. If a child has a flare up of a chronic disease, this is best managed by their regular doctor, unless one of the above rules for going to the ER applies.
I have asked my sister to take her boys to convenient care a few times. A few weekends ago, she texted a picture of my nephew’s throat which looked obviously like strep. Given that it was a Saturday night, I asked her to go to a convenient care the next day. Similarly, their other little boy got swimmer’s ear while on vacation and convenient care was the best option. Anytime you have a problem that could be easily managed by your primary doctor, but the doctor’s office is closed or you can’t get in for a few days, consider convenient care.
If you have questions, please reach out to your pediatrician.
For further information about UofL Pediatrics, visit the practice website. To learn more about Dr. Stiff, visit her physician profile. If you don’t have a pediatrician, we would love to see you in one of our metro Louisville locations. You can request an appointment online, or call (502) 588-6000.
