Bright Futures

It’s 10 p.m. on Tuesday and your little one has a runny nose and a fever of 101 degrees. Could this be just a cold that will resolve by itself, or should you rush to urgent care or even the emergency room? Is it best to wait until the morning and make an appointment with your regular pediatrician?

We’ve all been there – and the decision isn’t easy. Of course, the global pandemic adds another layer of complication. Don’t fret: Use the tips in this article to simplify the decision-making process!

The all-too-common cold

Most children contract four-to-six viral upper respiratory infections (URIs) – commonly referred to as “colds” – each year, especially if they attend daycare or school. These URIs consist of typical cold symptoms like runny nose, mild fevers (100.4 to 101), sore throat and cough. In general, these common colds will resolve on their own within seven to 10 days with the help of:

• Simple rest and fluids
• Tylenol for fever and pain (although not always necessary, as fevers actually help our bodies fight infections)
• Nasal saline and bulb suction for stuffy noses in infants and children 2 years old and younger
• Humidifier in the room when sleeping

In general, your child does not necessarily need to see a medical provider for the common cold, but you are always welcome to make an appointment if you are unsure or worried. However, there are some occasions when a pediatrician should always be consulted at the first signs of illness: If you baby is under three months of age, or if your child has a preexisting condition (heart condition, immunodeficiency, cancers, etc.), contact your child’s doctor right away.

When a cold is not just a cold

Sometimes a child’s illness can mimic a cold but may actually be something more serious. Also, some colds can persist and lead to secondary infections like ear infections. Seek prompt medical attention if your child is experiencing any of the following symptoms:

• Shortness of breath: Can present as unusually rapid or shallow breathing in younger children, nasal flaring (nostrils get larger with each breath) or chest retractions (the skin above or below the ribs sucks in with each breath)
• Appears unusually sleepy or fussy
• Fever of 103°F (39.3°C) or higher, or a fever of 101°F (38.0°C) or higher for more than 2-3 days
• Nasal mucus lasting longer than 10-14 days (could be a sinus infection)
• Cough lasting longer than a week (could be a pneumonia)
• Ear pain or tugging on ear (could be an ear infection)      

ER, Urgent Care or PCP?

Emergency rooms and the people who work there are literal life savers. While the ER is open 24 hours a day and will see everyone, it may not be the best place for all sick visits. In general, ERs should be reserved for serious illnesses, injuries like fractures or stitches or when a simple illness takes a turn for the worse. For example, if that mild cough turns into shortness of breath or a tummy ache turns into severe pain, the ER is the best place to go. In cases of mild illness like a simple cold, it’s best to avoid the ER and allow the staff to concentrate on children facing real emergencies who require a very high level of care.

Urgent care clinics primarily serve as an after-hours extension of your regular PCP for sick visits. Parents typically visit urgent care for stomach flus (few days of vomiting/diarrhea), earaches and rashes. If you’re not sure your child you can wait, visit any of Phoenix Children’s four urgent care clinics.

If you feel your child can wait until the following day to see their PCP, opt for this option as your PCP will already be familiar with you and your child. Many PCPs, including providers in Phoenix Children General Pediatrics Department, are offering telehealth visits, which allow you to speak with your doctor from the safety and comfort of your home.

Parental Intuition

Deciding when to seek medical care is not always easy, but parents know their children best. My recommendation is to make a clear-headed assessment of the actual symptoms and then go with your gut instinct, as it will usually be right.

We hope these guidelines aid you in making decisions when your children get sick late at night!