6 Signs Your Child Should Go to the ER

A sick child can be a scary thing for parents. A call to the pediatrician can calm your fears, but these 6 signs and symptoms could mean a trip to the ER.

Medically reviewed in August 2021

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A sick child can be a scary thing—especially for new parents. Everything from bumps and bruises to nagging coughs can send you and your little one to the emergency room—and you aren’t alone. Nearly 25.5 million visits to the ER were reported for children under 18 in 2010, according to the Agency for Healthcare Research and Quality. Many times, a quick call to the pediatrician can calm your fears, but when these 6 signs and symptoms strike, it may be time to make a trip to the hospital.

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A fever is one of the leading causes of ER visits in boys and girls. Luckily though, a fever doesn’t usually warrant a trip to the hospital and, unless the child has been out in the heat, it can be monitored at home. Pediatric emergency physician, Kimberly Naftel, MD, from The Children’s Hospital at TriStar Centennial says, “In general, fevers are not considered dangerous … they’re [actually] a sign that your child is fighting an infection.” For babies 3 months and younger, call the doctor if the rectal temp is higher than 100.4°F. And make note if your child is acting significantly different, doesn't seem as alert or shows signs of dehydration. Head straight to the ER if the fever induces a seizure.

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Tummy Troubles

Pinpointing the cause of your child’s stomach pain can be tricky—everything from strep throat to food allergies can cause stomach discomfort. But does that mean you should head to the ER?

If your child is complaining of a tummy ache that doesn’t go away after a couple of hours, or comes with fever, vomiting, diarrhea, lack or loss of appetite or signs of dehydration, call your doctor. If your little one is drowsy, weak or faint, has a hard or swollen belly, tender abdomen (especially on the lower right side), if the pain gets worse or they aren’t able to walk, if there’s blood in the stool or they're constipated, skip the phone call and make a trip to the ER.

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Widespread Rash

Everything from laundry detergent to the family pet can cause a rash on your kids’ sensitive skin. The tricky part is deciding if it’s cause for alarm.

Usually, skin irritation will clear up in a few days. If that’s not the case though, or if your child is exhibiting any of these other symptoms, head to the ER: trouble breathing, fever, swelling or blistering, headache, joint pain, abnormal bleeding or sickly appearance. Dr. Naftel also recommends pressing on the rash. If you take your finger away and the rash is still red, or doesn’t turn white under your finger, it could be a petechial rash, which could be more serious.

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Bumps, Bruises and Broken Bones

With kids, slips and falls are bound to happen. Safe Kids Worldwide reports that up to 9 million are treated for these injuries in the ER each year. But does a bump mean you should make a beeline to the hospital? If your child's bumped his head, look out for these signs over the next 36 to 48 hours: consistent crying, dizziness, vomiting, drowsiness, inability to speak/slurred speech, inability to balance when standing or sitting and changes in personality. For broken bones, look for a loss of movement or bone pushing through the skin. A body part near a broken bone may be numb, tingling, weak, cold or pale.

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Stiff Neck

A stiff neck can occur for many reasons, like sleeping in an uncomfortable position or playing on an iPad too long. But it's important to be aware that a stiff neck can also signal something more serious. Neck pain and a fever of over 100 could be an early sign of meningitis, and a stiff neck that occurs within a month of a tick bite could indicate Lyme disease.

Also, “if the child is unable to put their chin on their chest, that could indicate viral or bacterial meningitis,” says Dr. Naftel. “If there’s an obvious swelling, that would be concerning as well.”

Also watch for a stiff neck that occurs with numbness in the back or arms, sensitivity to light, vomiting, drowsiness or fever.

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Trouble Breathing

It's scary for a parent to see their child having trouble breathing, and while it can indicate a serious condition, it's often caused by an underlying condition like croup or bronchiolitis that can be treated by a pediatrician.

Dr. Naftel advises to seek immediate care “if your child has choked on an object or if the trouble is persistent, [and you can] lift up their shirt and look at their tummy to check. If they’re using their belly to breathe or the muscles in between their ribs, it could indicate significant respiratory distress and warrant a trip to the ER.”

Fevers can also sometimes cause rapid breathing. If your child isn’t in distress, bringing down the fever may help.

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When In Doubt, Call a Doctor

It can be hard to decide when a situation calls for a trip to the hospital, but when it comes to the health of your kids, it’s better to be cautious. Making a call to the doctor can help to calm your fears, and they’ll often direct you as to the best course of care.

However, a child that has a deep wound, severe burns, trouble talking or moving, appears cold or pale, is having severe chest pain or is hard to wake up needs to go to the ER right away. “If you have any concerns, or think you’re dealing with a life-threatening situation, seek immediate care at the closest ER,” says Dr. Naftel.

And for help locating a pediatrician in your area, try the Find a Doctor tool.

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