When to use the emergency room - child

How quickly does your child need care? If your child could die or be permanently disabled, it is an emergency.

Call 911 or the local emergency number to have the emergency team come to you right away if you cannot wait, such as for:

• Choking
• Stopped breathing or turning blue
• Possible poisoning (call the nearest Poison Control Center)
• Head injury with passing out, throwing up, or not behaving normally
• Injury to neck or spine
• Severe burn
• Seizure that lasted 3 to 5 minutes
• Bleeding that cannot be stopped

Go to an emergency department or call 911 or the local emergency number for help for problems such as:

• Trouble breathing
• Passing out, fainting
• Severe allergic reaction with trouble breathing, swelling, hives
• High fever with headache and stiff neck
• High fever that does not get better with medicine
• Suddenly hard to wake up, too sleepy, or confused
• Suddenly not able to speak, see, walk, or move
• Heavy bleeding
• Deep wound
• Serious burn
• Coughing or throwing up blood
• Possible broken bone, loss of movement, primarily if the bone is pushing through the skin
• A body part near an injured bone is numb, tingling, weak, cold, or pale
• Unusual or bad headache or chest pain
• Fast heartbeat that does not slow down
• Throwing up or loose stools that do not stop
• Mouth is dry, no tears, no wet diapers in 18 hours, soft spot in the skull is sunken (dehydrated)

When your child has a problem, do not wait too long to get medical care. If the problem is not life threatening or risking disability, but you are concerned and you cannot see the provider soon enough, go to an urgent care clinic.

The kinds of problems that an urgent care clinic can deal with include:

• Common illnesses, such as colds, the flu, earaches, sore throats, minor headaches, low-grade fevers, and limited rashes
• Minor injuries, such as sprains, bruises, minor cuts and burns, minor broken bones, or minor eye injuries

If you are not sure what to do, and your child does not have one of the serious conditions listed above, call your child's provider. If the office is not open, your phone call will be forwarded to someone who can help. Describe your child's symptoms to the person who answers your call, and find out what you should do.

Your child's provider or health insurance company may also offer a nurse telephone advice hotline. Call this number and tell the nurse your child's symptoms for advice on what to do.

Before your child has a medical problem, learn what your choices are. Check the website of your health insurance company. Put these telephone numbers in the memory of your phone:

• Your child's provider
• Emergency department your child's doctor recommends
• Poison control center
• Nurse telephone advice line
• Urgent care clinic
• Walk-in clinic

Emergency room - child; Emergency department - child; Urgent care - child; ER - when to use

American College of Emergency Physicians: Emergency Physicians.Org website. Know when to go. www.emergencyphysicians.org/articles/categories/tags/know-when-to-go. Accessed December 9, 2022.

Dearstyne NM, Markovchick VJ. Decision making in emergency medicine. In: Bakes KM, Buchanan JA, Moreira ME, Byyny R, Pons PT, eds. Emergency Medicine Secrets. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 1.

Updated by: Charles I. Schwartz MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.