When to Call the Doctor

One of the hardest questions a parent faces is when to call the doctor. Here is a simple way to answer it — “Whenever you are concerned about your child’s health or well-being.”

This is a good rule to follow when deciding whether to call your pediatrician or family practitioner’s office. It is essential that you have a physician’s office that encourages your questions and provides an atmosphere for you to feel comfortable asking any question, no matter what the question is. You should never be made to feel badly for calling or asking any questions.

In this article, we will look in more detail at the issues surrounding how parents can better decide when it may be time to call the doctor. For a summary, click on the links below:

* When to call the Rescue Squad
* When to call Poison control
* When to call the doctor

Parents have to learn to be parents, and new mothers and fathers will feel particularly anxious about their new babies. They have to learn about the routine care of their infant, as well as how to handle common problems and illnesses. This is a learning process and part of the training is done through phone consultations with the staff at your pediatrician’s office. As a parent gains more experience and the confidence that goes with it, they will find that they need to call less.

Raising and caring for children is a process of education. Most parents do not have medical training. Some problems seem very serious to the parent, but the pediatrician knows that there is nothing to worry about. On the other side of the coin, parents may not always know when something that seems trivial is really an important sign of a problem.

Reading basic health information about children can help you become aware of what problems may arise and what you can do at home first. Take notes when your physician or their staff gives advice. Don’t be afraid or embarrassed to ask questions when you think of them in the office. If the doctor has left the room, tell the nurse you have one more question.

The age of the child is important as well in deciding when to call the doctor . A general rule is that the younger the child, the more urgent is the question. For example if a 3-year-old has a fever, this may not be as urgent as a 3-month-old with a fever is. Never underestimate your parental instincts. Parents know their children best. They often know that something is not right, even before it is obvious to someone else. If you are worried, we as physicians need to be concerned.

Parents sometimes wonder if they ask too many questions or if they are overanxious about a problem. An experienced and sensitive pediatrician or nurse will pick up on this and will discuss where this anxiety may be coming from. For example, a parent who expresses concern about frequent bruising or enlarged lymph nodes may really be concerned about the possibility of cancer. It is not until asked directly by a physician that they usually admit this. Once they have voiced their real concern, it can be addressed properly and hopefully, their mind set at ease.

Another frequent situation that arises at the doctor’s office is when a parent appears to be worried about a variety of small problems. The reality is that there are often some major social problems occurring at home which the parent has difficulty discussing. Sometimes the question that is not asked is as important as the question that is asked. Physicians are trained to recognize these situations and in turn, do what they can to offer support and guidance.

Lastly, remember that nothing can replace a good relationship with the physicians and the nurses in your doctor’s office. As time goes on and you get to know and understand one another, knowing when to call the office will become a natural response.

When to call the Rescue Squad
There are some problems when it is best to call the Rescue Squad first. Make sure the phone number is posted near every phone in the house.

  • Severe difficulty breathing, especially with blue coloring, or after choking.
  • Serious injury (especially with massive bleeding, obvious broken bones, or severe head trauma with loss of consciousness.)
  • Electrical shock or burn
  • Allergic reaction (especially with difficulty breathing, airway swelling or wheezing, or any of the above with hives)

When to call Poison Control
AND REMEMBER TO CALL POISON CONTROL FIRST AFTER AN INGESTION. Then follow instructions on whether to call your doctor’s emergency line or go directly to the Emergency Room. Post the number for POISON CONTROL right near every phone. You can find this number in your local phone book or at The American Association of Poison Control Centers.

When to call the doctor
1. You should call your physician’s office or page the doctor on call immediately for the following problems:

  • Any infant under 3 months with fever. (100.5 or greater taken rectally)
  • Any infant who is acting very irritable and lethargic, or inconsolable. (no periods of alertness, no sucking, no eye contact.)
  • Any child with fever of 105 or greater.
  • Any child with a fever lower than 105, but who appears “toxic”. (unresponsive, lethargic, won’t smile, decreased eye contact.) or with redness and swelling of the eyelids, jaw, or any joint in the body.
  • Difficulty breathing (due to anything other than a stuffy nose)
  • Wheezing (with rapid respirations, cough, or deep movements of the chest & neck muscles with a breath, especially in an anxious child)
  • Croup (especially in an anxious child or if croup symptoms are unresponsive to steam or cool air)
  • Stridor (a noise made by an infant or child on inspiration)
  • Severe abdominal pain
  • Forceful vomiting (projectile or with blood, especially in an infant)
  • Explosive or bloody diarrhea
  • Signs of dehydration (decreased urination or wet diapers, dry mouth, no tears, sunken eyes.)
  • Head trauma (especially if there was any loss of consciousness or vomiting afterwards.)
  • Stiff neck (especially in an ill appearing child or child with fever.)
  • Severe headache (especially when accompanied by fever or with any visual changes, balance disturbances, or loss of the use of a limb or inability to walk)
  • Severe pain anywhere on the body.
  • Animal or human bites (especially if the skin is broken)
  • Hives over a large area of the body (especially if there are any swollen joints)

2. You should call the office within a day:

  • Asthma (known asthmatic with mild symptoms or those not responding to the usual treatments)
  • Cough (accompanied by chest pain, fever, or lasting more than a week)
  • Fever lasting more than 3 days
  • Sore throat with fever, pus on tonsils, swollen glands.
  • Earache in an older child, or concern that your infant may have an ear infection (cries whenever they are laid down, bats at ear, disrupted sleep)
  • Diarrhea (if you have not received instructions on what to do or if what you are doing is not working.)
  • Vomiting (for longer than 24 hours or if what you are doing is not working or your child seems to be getting worse.)
  • Eye infections.
  • Rashes or skin infections (including impetigo, ringworm, diaper rash)
  • Hives (without difficulty breathing or wheezing, or swelling of joints)
  • Poison ivy (with swelling of face, eyes, or covering large area of body)
  • Pain or burning on urination.
  • Abdominal pain
  • Chicken pox complications or questions
  • Lyme Disease (Lyme rash, fever, joint pain)

3. You should call the office to discuss the following non-urgent problems or to make an appointment:

  • Symptoms that have been going on for some time like frequent headaches, frequent abdominal pain, bedwetting, rashes, constipation.
  • Concerns regarding emotional or behavioral problems, or problems in school.
  • Concerns regarding your child’s growth or development.