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Experts Weigh In: When to Take Your Child/Infant to the Emergency Room vs. Pediatrician February 13, 2019

Longview – From high fevers to broken bones, there are a host of issues that arise daily for children and infants that are treated in the clinics and hospitals of CHRISTUS Good Shepherd Health System. Knowing where and when to seek the appropriate care is always the first step to getting your child back on their feet.

“As health care providers – and as parents’ ourselves – we understand that sometimes it can be difficult to know when a trip to the emergency department is necessary,” said Jaime Powell, Clinical Director ER, CHRISTUS Good Shepherd Medical Center. “The most important thing is the health and wellness of your child, so if there is an emergent situation, please don’t hesitate to go to the ER or call 911.”

Powell mentioned a number of signs and symptoms that should prompt immediate action:

  • Fainting, loss of consciousness, seizure or convulsion
  • Fever (temperature > 100.4) in a newborn
  • Rapid or difficulty breathing, visibly using chest and stomach muscles to breathe
  • Sudden dizziness, weakness or change in vision
  • Change in behavior, such as confusion or difficulty waking
  • Severe or persistent vomiting or vomiting blood
  • Severe or persistent diarrhea or blood in stools
  • Vomiting and/or diarrhea with dry lips or mouth and/or decreased urination
  • Profuse bleeding or bleeding that won't stop with direct pressure after 15 minutes
  • A gaping wound with edges that don't come together
  • Problems with movement or sensation after an injury
  • A stiff neck associated with fever or headache
  • Accidents involving pedestrians or bicycles and cars
  • A red/purple rash that doesn't disappear when brief fingertip pressure is applied to the skin
  • A bulging or sunken fontanel (soft spot) in infants
  • Sudden severe pain anywhere in the body
  • Falls from any significant height

“Despite every parent’s best efforts, children do get sick and injured, so one of the most important things you can do as a caregiver is to be prepared,” said Powell. “Before an emergency happens, talk to your physician about accident prevention and emergency care. And if possible, take courses in CPR and first aid. If you do have to take your child to the ER, it helps to have key information ready to share with the nurses and doctors. Keep track of when the illness began, how it progressed, the progression of a fever or rash, how often the child has gone to the bathroom, any medications they have taken/take regularly, and any other health concerns.”

Luckily, experts say that in most cases, a visit to the pediatrician will be able to provide care that is more than sufficient to help your child to feel better.

“While some situations are severe and have a straightforward response, such as a broken bone or loss of consciousness, there are others where the answer may not be so clear – especially for infants and young children,” said Sanjeev Kota, M.D., CHRISTUS Trinity Clinic Pediatrician. “Things like fevers and common colds can be treated at home, but sometimes require a call or trip to the pediatrician.”

Dr. Kota recommends the pediatrician for a fever if the child is an infant under three months of age with any fever; for children 3-6 months and older temperature of 101 degrees F or higher; or if the child is older than three months and the fever has lasted more than three days. You can contact your pediatrician for any fever over 101 degrees F.

If your child has a cold, Dr. Kota suggests contacting the pediatrician if the following symptoms arise: earache; fever over 101-102 degrees F; if they become exceptionally sleepy, cranky or fussy; if a skin rash develops; if breathing becomes rapid or labored; or if their cough becomes persistent or severe.

“And, remember that it is always important to speak to your doctor before giving any cold medications to an infant,” said Dr. Kota. “If you are ever in doubt about your child's symptoms or health, it is always best to call your doctor.”

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CHRISTUS Good Shepherd Health System includes: CHRISTUS Good Shepherd Medical Center – Longview (425-bed count); CHRISTUS Good Shepherd Medical Center – Marshall (149-bed count); freestanding Emergency Departments, CHRISTUS Good Shepherd NorthPark and CHRISTUS Good Shepherd Emergency Center – Kilgore; medically integrated wellness centers, CHRISTUS Good Shepherd Institute for Healthy Living and CHRISTUS Good Shepherd LifeCenter; and CHRISTUS Trinity Clinic. CHRISTUS Trinity Clinic is the area's preferred multi-specialty medical group, with more than 650 Physicians and Advanced Practice Providers representing 41 specialties in 82 locations serving Northeast Texas across 41 counties. For more information on services available through CHRISTUS Good Shepherd Health System, visit