What Symptoms Should be Considered an Emergency?

Parents often have a difficult time determining when their child’s symptoms should be considered an emergency. Some parents may worry that they are calling too soon and other parents may dismiss emergency symptoms as “not serious.” Below are conditions we feel require immediate treatment. You should call at once if your child experiences any of these symptoms:

The information on this web site is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a health care professional.

Abdominal Tenderness

Your child’s tummy should be soft even when she has a stomachache. Try pressing on your child’s tummy while she is distracted (such as when sitting on your lap while reading a story). You should be able to press in about an inch in all parts of the tummy without resistance or screaming. The tummy should not be bloated or hard.

Bluish Lips

Blue color of the lips and mouth (cyanosis) can indicate your child is not getting enough oxygen.

Breathing Difficulty

This is not the same as the noisy breathing caused by a stuffy nose. Watch and listen to your child breathe after you have cleaned out her nose and when she is not coughing. Call if your child has any of the following:

Obvious breathing difficult
Rapid breathing (more than 50 breaths per minute in a child under 6 months, more than 40 breaths per minute from 6 months to 4 years or more than 30 breaths per minute if older than 4 years)
Bluish lips
Moaning or grunting with each breath
Pulling or sucking in between the ribs or at the bottom of the neck (retractions)

Bulging Soft Spot

If your infant’s soft spot (fontanel) is tense and bulging out it may mean the brain is under pressure. Since the fontanel normally bulges when the baby is crying, check it when your baby is quiet and in an upright position. It is normal to see the soft spot pulsate at times.

Dehydration

Dehydration means that your child’s body fluids are low and usually follows vomiting or diarrhea. Signs of dehydration include:

No urine or wet diaper in eight hours
Sticky dry tongue
Sunken in soft spot
Sunken eyes
No tears when crying (infants less than 2 months do not normally tear)

Drooling

The sudden onset of drooling in a non-teething child, especially if it occurs with difficulty swallowing, can mean a serious infection of the tonsils, throat, or windpipe.

Infant Fever

Call immediately if your infant is less than three months old and has a rectal temperature of 100.4 or higher. Fever is more concerning in infants because at this age they are harder to evaluate. They may not smile or coo yet, and they often do not have regular sleeping and eating habits and so can be difficult to tell how sick they are. In infants, a rectal temperature less than 97 may also be serious.

Lethargy (extreme)

Tiredness and increased sleeping during an illness is normal. However, if your child stares into space, won’t smile, can’t play, is too weak to cry, is floppy, or hard to awaken you should call us. Lethargy does not mean the punkiness that some children experience when not feeling well.

Neck Injury

Any significant neck injury should be reported, even if your child seems fine.

Neck Stiffness

A stiff neck can be a sign of meningitis, especially if it is associated with a fever. Ask your child to touch his chin to his chest. If they cannot, let us know immediately.

Newborn Illness

If your baby is less than six weeks old, you should call anytime they seem sick.

Pain (severe)

Call if your child cries when you touch or move him. A child with severe pain may not want to be held. Constant screaming may also point to severe pain.

Poisoning

If your child ingests (eats) anything you feel may be poisonous, please call poison control center at 1-800-222-1222.

Purple Spots

Purple spots on the skin can be a sign of serious bloodstream infection, with the exception of explainable bruises.

Testicular Pain

Sudden onset of severe pain in the groin or testicle can be from twisting (torsion) of the testicle. This requires surgery within eight hours to save the testicle.

Walking Difficulty

If your child has learned to walk and then stops walking it may indicate a serious injury or problem with balance. A child who walks bent over, holding his belly may have a serious abdominal problem, such as appendicitis.