You should seek medical attention if:
- After hours, your child has one of the four complications of a cold (ear infection, sinus infection, pneumonia, bacterial bronchitis) with a fever for more than 5 days over 101 degrees. Your doctor may call in an antibiotic and check your child during regular office hours, or he/she may want your child evaluated in a clinic or ER first.
- Your child has moderate wheezing that is causing some tugging in the front of the neck and ribs, but it doesn’t seem to be slowing him down or causing much distress. Your doctor can probably prescribe some medication over the phone to help with the wheezing until the morning. If this happens in the middle of the night, try steaming him before you page the doctor. No need to page the doctor if the wheezing is mild and not troubling your child at all. This can wait to be seen in the office.
- Your child has moderate croup. See Croup for more info on how to treat this and what signs warrant a call to your doctor.
You should take your child into an ER right away if:
- Your child has severe wheezing that is causing him significant difficulty breathing.
- Your child has severe croup and is having significant difficulty getting air in.
- Your child’s lips or mouth are turning blue due to labored breathing or shortness of breath.
- Your child’s breathing is rapid and labored. Count the number of breaths he takes in 30 seconds, multiply it by two, and this gives you his breaths per minute. Go to the ER right away if the breaths are greater than 60 per minute for children under a year, greater than 50 for children 1 through 4, and greater than 40 for children 5 and older. Be aware that fever alone can cause rapid breathing (and a rapid heartbeat). Reduce the fever first and then evaluate your child’s breathing.
- Your child seems to have whooping cough and during these severe coughing fits turns blue around the mouth and lips.
Above all, if you are not certain about the status of your child’s breathing, and feel he is in urgent need of an immediate medical decision, then call your doctor.