When your child is sick or injured, it can be hard to know where to go for help. Some illnesses and injuries can wait until your child’s pediatrician is available, while others need to be evaluated the same day. A few situations require immediate medical attention in an emergency room (ER).
Knowing the difference between these care options can help you make informed decisions, avoid unnecessary visits and costs, and—most importantly—make sure your child gets the right care when they need it.
Below, we’ll walk through when to call your child’s pediatrician, when urgent care may be appropriate, and when it’s time to head to the ER or hospital emergency department, along with common examples and warning signs to watch for.
Breaking Each Down:
Pediatrician’s Office
Your child’s pediatrician knows their medical history, vaccination record, growth patterns, and overall health. This makes the pediatrician’s office a great choice for routine care, follow-up visits, ongoing health concerns, and questions that don’t require immediate attention. Many pediatric practices also keep same-day appointments available for children who become sick unexpectedly.
Your child’s pediatrician can help with concerns such as:
- Constipation: Your child has had trouble passing stool for several days but otherwise feels well and isn’t having severe pain. Your pediatrician can offer advice about diet and fluids, recommend treatment when appropriate, and arrange follow-up if needed.
- Mild rash: A rash that isn’t spreading quickly and is not itchy or is only mildly itchy may be appropriate for a pediatrician visit.
- Recurring ear infections: If your child has frequent ear infections, especially following colds, their pediatrician can monitor their ears and hearing and determine whether an ear, nose, and throat (ENT) specialist may be needed.
- Growth concerns: If your child isn’t gaining height or weight as expected—or their growth pattern changes significantly—the pediatrician can review their nutrition, monitor their growth over time, and order additional testing when appropriate.
Parent tip: Not sure where to go? Start by calling your pediatrician’s office. Many practices offer after-hours nurse lines or other resources that can help you decide what type of care your child needs.
Urgent Care
Urgent care can be a good option for illnesses and injuries that aren’t life-threatening but shouldn’t wait several days to be evaluated. Many urgent care centers offer extended hours, including evenings and weekends, and may accept walk-ins or appointments.
Urgent care can provide quicker access to care for many common illnesses and injuries and may be less expensive than an ER visit. When available, pediatric urgent care is often the best choice, since these centers are specifically equipped to care for children.
Urgent care may be appropriate for concerns such as:
- Ear pain: Your child has ear pain or other symptoms that could indicate an ear infection.
- Sprained or injured ankle: There is noticeable swelling or bruising, and your child has difficulty putting weight on the foot.
- Cut that needs repair: A wound may need stitches, medical glue, or thorough cleaning.
- Flu-like symptoms: Your child has fever, chills, body aches, and cough but is drinking fluids, urinating normally, and breathing comfortably.
- Mild breathing difficulty: Your child is breathing faster than usual or has mild noisy breathing or increased effort.
- Possible broken bone: You suspect a fracture, but there is no obvious deformity or bone sticking through the skin.
- Possible allergic reaction: Your child develops swelling, a rash, or hives and may have other symptoms that need prompt evaluation.
Important: Some symptoms that initially seem mild can become emergencies. If your child has severe trouble breathing, significant swelling of the face or mouth, loss of consciousness, or other signs of a life-threatening reaction, skip urgent care and call 911 or go directly to the ER.
Emergency Room (ER)
A hospital emergency department (ER) is equipped to handle serious and potentially life-threatening conditions that require immediate medical attention. Emergency departments have access to emergency physicians, nurses, advanced imaging such as X-rays and CT scans, and surgical care when necessary.
Go to the ER for signs of a serious emergency, including:
- Severe breathing problems: Your child’s ribs or chest are visibly pulling in with each breath (called retractions), their lips look blue, or they’re unable to speak normally because they’re struggling to breathe.
- A first-time seizure: Your child has unusual shaking, stiffening, or other abnormal movements along with a loss of consciousness and does not have a known seizure disorder.
- Serious injury: Your child has a head injury followed by vomiting, confusion, or loss of consciousness; an injury with an obviously deformed bone; or a possible spinal injury after a significant fall or collision.
- Severe dehydration: Your child has prolonged vomiting or diarrhea and is too weak, sleepy, or ill to drink enough fluids.
- Severe abdominal pain: Your child has significant or worsening stomach pain, especially if they are very uncomfortable or have considerable pain when the abdomen is touched.
When in Doubt, Reach Out
When you’re unsure where to take your child, calling your pediatrician’s office can be a great first step. Your child’s healthcare team can help you determine whether your child should be seen in the office, evaluated at urgent care, or taken directly to the ER.
And remember: If you believe your child is experiencing a life-threatening emergency, don’t wait for a callback—call 911 or go to the nearest emergency department.
When & Where – Fever
Fever is usually a sign that your child’s body is fighting an infection. Viral infections, such as colds and the flu, are common causes, but bacterial infections, such as strep throat or a urinary tract infection (UTI), can also cause fever.
While it’s natural to focus on the thermometer, your child’s overall appearance and behavior can tell you even more than the temperature itself. A child with a higher fever who is drinking, playing, and acting mostly like themselves may be less concerning than a child with a lower fever who is unusually sleepy, weak, or difficult to wake.
When Can You Care for a Fever at Home?
Many short-term fevers can be monitored at home when your child is otherwise doing well. Home care may be appropriate when your child has:
- A fever with mild cold symptoms and good energy. For example, your 5-year-old has a temperature of 102°F along with a runny nose and cough but is still laughing, playing, and eating snacks.
- A fever that improves with fluids and fever-reducing medicine. For example, your toddler’s fever comes down after acetaminophen, and they become more comfortable and energetic enough to drink, eat a snack, or play.
Keep your child comfortable, encourage plenty of fluids, and continue to watch how they’re acting and feeling.
When Should You Call Your Pediatrician?
A pediatrician visit or next-day evaluation may be appropriate when:
- Your child’s fever has lasted less than 3 days but you have other concerns. For example, your 8-year-old has had a temperature of 101°F for 2 days and a mild sore throat but is drinking normally. Your pediatrician can determine whether testing for strep or another illness is needed.
- The fever goes away and then comes back. For example, your child’s fever disappears for a day but returns for another couple of days without an obvious reason.
- Your child has an ongoing medical condition. If your child has a chronic health condition, such as asthma or a heart condition, talk with their pediatrician about whether the fever could cause additional concerns.
When Should You Go to Urgent Care?
Same-day evaluation may be appropriate when:
- The fever lasts more than 3 days without getting better. For example, your 4-year-old has had a temperature between 101°F and 102°F for 4 days. They’re still eating and drinking but are more tired than usual.
- Your child develops other symptoms that need evaluation. These may include ear pain, a sore throat, or a cough that is getting worse. For example, your 7-year-old has a fever and keeps holding their ear, or your child has a fever along with a worsening barky cough.
When Is a Fever an Emergency?
Go to the emergency room right away if:
- A baby younger than 3 months has a temperature of 100.4°F (38°C) or higher. For example, your 6-week-old has a rectal temperature of 101°F, is feeding less than usual, and feels warm. Young infants can become seriously ill quickly and need prompt medical evaluation.
- Your child is having trouble breathing. This may include very fast breathing or the skin pulling in between or around the ribs with each breath.
- Your child is unusually difficult to wake or unresponsive. Extreme sleepiness or difficulty waking your child with gentle stimulation can be a warning sign.
- Your child has persistent vomiting and cannot keep fluids down.
- Your child has a stiff neck and is unusually sensitive to light. These symptoms can be signs of meningitis and require immediate evaluation.
- Your child suddenly develops a purple or bruise-like rash. A rapidly appearing purple rash can be a sign of a serious infection and should be evaluated right away.
Parent Tip: Watch Your Child, Not Just the Thermometer
When your child has a fever, look at the whole picture. If the fever is gradually coming down, your child is drinking well, and their energy and behavior improve between fevers, those are reassuring signs.
On the other hand, if your child’s behavior is getting worse, they’re having more difficulty breathing, they’re not drinking, or new concerning symptoms develop, don’t wait for the fever to reach a certain number before seeking care. Your child’s symptoms and overall condition are important parts of deciding when they need medical attention.
When & Where: Injuries
It isn’t always easy to tell whether an injury is minor or needs immediate medical attention. Knowing the warning signs can help you get your child the right care without unnecessary delays.
When Should You Go to Urgent Care?
Urgent care may be appropriate for injuries that need to be evaluated the same day but don’t appear to be life-threatening, such as:
- Mild swelling or pain after a fall. For example, your 9-year-old twists an ankle at recess and is limping but can still put some weight on it. There’s some swelling, but the ankle doesn’t look deformed.
- A possible fracture without an obvious deformity. For example, your 6-year-old falls from a low jungle gym and develops wrist pain. They don’t want to use that hand, but the wrist looks straight. Urgent care can often perform X-rays and provide a splint if needed.
- A cut that may need stitches or another type of wound repair. For example, your child hits their head on the corner of a table and develops a deep cut. The bleeding stops after about 10 minutes of firm pressure, but the edges of the wound don’t come together on their own. Because not every urgent care center offers the same wound-repair services, calling ahead can help you determine whether they can treat the injury.
When Should You See Your Child’s Pediatrician?
A pediatrician visit may be appropriate when an injury isn’t an emergency but symptoms continue or don’t improve as expected. Examples include:
- A limp that continues after a minor injury. For example, your child twists their ankle and can still walk, but they’re still limping the following day. Their pediatrician can evaluate the injury and determine whether additional testing is needed.
- Mild symptoms after a head injury that don’t go away. For example, your child bumps their head and continues to have a mild headache two days later but has no vomiting, confusion, or other warning signs. Their pediatrician can help monitor for a possible concussion.
- Pain that doesn’t improve after a few days. For example, your child falls on their wrist. There isn’t much swelling, but the area remains sore and tender three days later.
When Is an Injury an Emergency?
Go to the emergency room right away for injuries that could be serious or life-threatening, including:
- A bone that is visibly bent, severely deformed, or sticking through the skin. For example, your 12-year-old falls off a bike and their forearm looks crooked, or you can see bone through the skin.
- A head injury followed by vomiting, confusion, a seizure, or loss of consciousness. For example, your 5-year-old hits their head on a trampoline, briefly loses consciousness, then vomits twice and seems confused or disoriented.
- Rapidly increasing swelling.
- Inability to put weight on a leg or foot.
- Refusal or inability to use an arm or hand.
Parent Tip: Not Every Fracture Looks Obvious
A broken bone doesn’t always look crooked or deformed. Significant pain, swelling, or a child’s refusal to use an injured arm or leg can still be signs of a fracture.
Many uncomplicated fractures can be evaluated and treated at urgent care, but obvious deformity, exposed bone, or other serious injuries require emergency care.
When & Where: Breathing Issues
Breathing problems can sometimes become serious very quickly in children. Knowing the warning signs of breathing distress can help you recognize when your child needs immediate medical attention.
When Should You Go to the ER?
Go to the emergency room right away if your child shows signs of severe or potentially life-threatening breathing problems, including:
- Blue or gray lips, tongue, or face. For example, your 4-year-old has the flu and begins breathing hard. You notice their lips or the area around their mouth turning bluish or gray. This can be a sign that they’re not getting enough oxygen.
- The skin is pulling in around the ribs or collarbone with each breath. This is called retractions and is a sign that your child is working very hard to breathe. For example, your toddler is breathing quickly and you can see the skin sucking inward between their ribs.
- Very fast or difficult breathing that interferes with talking. For example, your 10-year-old with asthma can only say a few words at a time before needing to gasp for air, even after using their inhaler.
- Chest pain along with fainting, dizziness, or confusion. For example, your teen develops chest pain while playing sports and then becomes dizzy or disoriented. This requires immediate medical attention.
When Should You See Your Child’s Pediatrician?
Some breathing concerns aren’t emergencies but should still be evaluated, especially when they happen repeatedly. Make an appointment with your child’s pediatrician for concerns such as:
- A cough or wheezing that keeps coming back. For example, your child develops a cough every time they catch a cold, and it continues for weeks afterward. Their pediatrician can evaluate whether asthma or another condition may be contributing.
- Mild chest discomfort that happens repeatedly. For example, your child occasionally says their chest feels tight while playing but doesn’t have severe symptoms. Their pediatrician can help determine whether asthma, muscle strain, or another condition may be responsible.
- Frequent need for a rescue inhaler. If your child with asthma needs their rescue inhaler more than twice a week, even when they’re not sick, their asthma may need to be reassessed and their treatment plan adjusted.
When Is Urgent Care Appropriate?
Urgent care may be a good option for mild to moderate breathing or chest symptoms that aren’t rapidly getting worse. Examples include:
- Cough, wheezing, or asthma symptoms that aren’t improving with home care but aren’t causing significant distress. For example, your child’s cough has lasted a week, and their inhaler only provides brief relief, but they can still talk, play, and interact normally.
- Mild chest discomfort without other warning signs. For example, your child develops a dull ache in their chest after coughing for several days but remains active and is breathing comfortably.
- Breathing faster or working somewhat harder than usual while remaining alert and interactive. For example, your child is acting normally but you notice that they’re breathing more quickly than they usually do.
Parent Tip: Know Your Child’s Asthma Action Plan
If your child has asthma, follow their asthma action plan and use their rescue inhaler exactly as directed by their healthcare provider.
If your child’s symptoms aren’t improving after following their prescribed rescue treatment, seek medical attention promptly. Don’t wait and see if breathing suddenly becomes much worse. Children’s breathing can deteriorate quickly, and severe breathing problems require immediate care.
If your child is struggling to breathe, has blue or gray coloring, becomes difficult to wake, or has another life-threatening symptom, call 911 or go to the nearest emergency department immediately.
When & Where: Skin & Eye Concerns
Most rashes and other skin changes in children are mild and temporary. However, certain changes in the skin—or symptoms that occur along with a rash—can be signs that your child needs to be evaluated.
When Can You Care for a Skin Problem at Home?
Minor skin concerns can often be monitored and treated with basic home care. Examples include:
- Mild eczema, bug bites, or diaper rash. For example, your toddler develops a few dry, irritated patches on their elbows and knees. Regular moisturizing and avoiding known irritants may help calm the flare.
- A mild rash that occurs along with cold symptoms. For example, your 6-year-old develops a light, spotty rash while they have a runny nose and cough but are still playing, eating, and drinking normally.
When Should You See Your Child’s Pediatrician?
Make an appointment with your child’s pediatrician for skin concerns that keep coming back, don’t improve, or need ongoing treatment, such as:
- Recurring or long-lasting skin problems. For example, your child’s eczema continues to flare despite regular moisturizing and over-the-counter treatments.
- Rashes that repeatedly return. For example, your child’s ringworm improves with treatment but comes back a few weeks later.
- A mild skin infection that may need prescription treatment. For example, your child develops impetigo, which can cause honey-colored, crusty sores around the nose or mouth. If the infection isn’t spreading quickly, their pediatrician can determine whether antibiotics or other treatment is needed.
- Pink eye that doesn’t go away. For example, your child’s eyes remain red and watery with mild itching for more than a week despite using allergy drops.
When Is Urgent Care Appropriate?
Urgent care can be a good option for skin problems that aren’t emergencies but should be evaluated promptly, including:
- Pink eye with eye discharge. For example, your child’s eye is red and has yellow or green crust or discharge in the morning, along with mild irritation, but they don’t have vision changes or significant swelling.
- Ringworm or an itchy rash that is slowly spreading. For example, a circular, scaly patch on your child’s arm has grown noticeably larger over a week and is itchy. This may need antifungal treatment. Your child’s pediatrician can also evaluate this type of rash.
- A rash with a mild fever when your child otherwise feels well. For example, your child has a low-grade fever and small red spots on their chest but remains playful, active, and comfortable. This can also be evaluated by your child’s pediatrician.
When Should You Go to the ER?
Go to the emergency room right away if your child develops skin changes that could indicate a serious or potentially life-threatening condition, such as:
- Purple or bruise-like spots that aren’t explained by an injury. For example, purple spots suddenly appear on your child’s arms or legs without any known bumps or falls. This can sometimes be a sign of a serious bleeding or clotting problem.
- Blistering or peeling skin, especially after starting a new medication. Large blisters or areas of skin that begin peeling can be signs of a serious reaction and require immediate evaluation.
Parent Tip: Take Photos of Changing Rashes
If your child’s rash is changing quickly, take a few clear, well-lit photos. A rash may look different—or even begin to fade—by the time your child is examined. Photos can give their healthcare provider a better idea of what the rash looked like at its most noticeable.
When NOT to Use Urgent Care
Urgent care is designed for short-term illnesses and injuries that need prompt attention but aren’t life-threatening. However, it isn’t a substitute for your child’s regular pediatrician when they need ongoing care, medication management, or monitoring for a chronic condition.
When Urgent Care May Not Be the Best Fit
Some health concerns require continuity of care, meaning consistent, ongoing care from a healthcare team that knows your child’s medical history and can monitor their health over time. Examples include:
- ADHD or other long-term medication refills: If your child runs out of their attention-deficit/hyperactivity disorder (ADHD) medication, their pediatrician is the better choice. These medications often require regular follow-up, monitoring, and sometimes specific paperwork that an urgent care center may not be able to provide.
- Ongoing asthma, diabetes, or heart condition management: If your child’s asthma has been getting worse over several weeks or their diabetes treatment plan needs to be adjusted, they need care from a provider who can review their history, monitor labs when needed, and make a long-term treatment plan.
- Comprehensive mental health evaluations: If your teen is experiencing anxiety, depression, or another ongoing mental health concern, urgent care may be able to assess immediate safety concerns, but it generally isn’t equipped to provide the detailed evaluation, therapy, and continued support these conditions may require.
Who Can Help With Ongoing Health Needs?
For long-term or complex concerns, these resources may be more appropriate:
- Your child’s pediatrician: Pediatricians provide ongoing medical care, routine physicals, vaccinations, growth and development monitoring, medication management, and referrals to specialists when needed.
- A behavioral health professional: Therapists, counselors, psychologists, and other behavioral health providers can help with concerns such as anxiety, depression, behavioral difficulties, ADHD management, and counseling.
- A community health clinic: Community clinics may offer affordable ongoing care for families who don’t have health insurance. Many use sliding-scale fees based on income and may also connect families with additional healthcare services or specialists.
Parent Tip: Establish a Medical Home
One of the best things you can do for your child’s health is to establish a medical home—a pediatric practice or clinic that provides consistent, ongoing care and maintains your child’s complete medical history.
Having a healthcare team that knows your child’s usual health, medications, growth, and medical history helps providers recognize when something has changed. It also makes it easier to coordinate care between your pediatrician, specialists, urgent care centers, and other healthcare providers when needed.
3 Questions to Ask Before You Go:
When you’re trying to decide what type of care your child needs, ask yourself:
- Is my child breathing comfortably and normally?
- Are they alert, responsive, and acting appropriately for them?
- Can they drink fluids and keep them down?
If the answer to any of these questions is no, your child may need urgent or emergency medical care. The severity of their symptoms will help determine where to go.
When in doubt, call your child’s pediatrician for guidance. If your child is having a life-threatening emergency, call 911 or go directly to the nearest emergency department.
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