Pediatric Emergencies: When to Go to Emergency vs Call Your GP or Dr Terry

As a parent, determining when your child needs emergency care versus routine medical attention can be one of the most stressful decisions you face. Dr Terry Nguyen, with clinical experience in emergency medicine and pediatrics, provides clear guidance to help Sydney parents navigate these critical decisions with confidence.

Understanding the difference between true pediatric emergencies, urgent care situations, and routine medical concerns can help you respond appropriately, potentially saving precious time in genuine emergencies while avoiding unnecessary emergency department visits for non-urgent issues.

This comprehensive guide provides evidence-based criteria to help parents make informed decisions about their child's medical care, whether that means calling 000, visiting the emergency department, contacting your GP, or seeking immediate consultation with Dr Terry for urgent pediatric care.

Life-Threatening Situations Requiring Emergency Services

Breathing and Airway Emergencies

• Severe Difficulty Breathing: Struggling to breathe, blue lips or face, unable to speak in full sentences
• Choking: Unable to cough, speak, or breathe due to blocked airway
• Severe Asthma Attack: Not responding to usual medications, extreme difficulty breathing
• Allergic Reaction (Anaphylaxis): Difficulty breathing, swelling of face/throat, widespread rash

Consciousness and Neurological Emergencies

• Unconsciousness: Child cannot be awakened or is unresponsive
• Seizures: First-time seizure or seizure lasting more than 5 minutes
• Head Injury: Loss of consciousness, persistent vomiting, confusion after head trauma
• Severe Drowsiness: Unusually difficult to wake or keep awake

Circulation and Bleeding Emergencies

• Severe Bleeding: Bleeding that won't stop with direct pressure
• Signs of Shock: Pale, cold, clammy skin with rapid pulse
• Chest Pain: Severe chest pain, especially with breathing difficulty
• Severe Dehydration: No urine for 8+ hours, sunken eyes, no tears when crying

Poisoning and Ingestion Emergencies

• Poisoning: Ingestion of toxic substances, medications, or chemicals
• Drug Overdose: Accidental ingestion of medications or substances
• Caustic Ingestion: Swallowing cleaning products or corrosive substances

Trauma and Injury Emergencies

• Major Trauma: Serious injuries from falls, accidents, or violence
• Suspected Fractures: Obvious deformity, inability to move limb, severe pain
• Burns: Large burns, electrical burns, or burns to face/hands/genitals
• Eye Injuries: Chemical in eyes, penetrating eye injury, sudden vision loss

Remember: When in doubt about a life-threatening emergency, always call 000. Emergency services would rather respond to a false alarm than miss a true emergency.

The ABCDE Assessment for Parents

Use this simple framework to assess your child's condition:

A - Airway and Breathing

• Emergency (000): Difficulty breathing, blue lips, choking
• Urgent (Dr Terry): Working harder to breathe, wheezing, persistent cough
• Routine (GP): Mild congestion, occasional cough

B - Behavior and Consciousness

• Emergency (000): Unconscious, unresponsive, severe confusion
• Urgent (Dr Terry): Unusually drowsy, irritable, or not acting like themselves
• Routine (GP): Mild behavior changes, normal alertness

C - Circulation and Color

• Emergency (000): Pale, blue, or mottled skin, severe bleeding
• Urgent (Dr Terry): Concerning color changes, moderate bleeding
• Routine (GP): Normal color, minor cuts or bruises

D - Dehydration and Disability

• Emergency (000): Severe dehydration, inability to move normally
• Urgent (Dr Terry): Signs of dehydration, concerning weakness
• Routine (GP): Mild dehydration, normal movement

E - Exposure and Environment

• Emergency (000): Poisoning, major trauma, severe burns
• Urgent (Dr Terry): Moderate injuries, concerning exposures
• Routine (GP): Minor injuries, routine environmental concerns

Age-Specific Considerations

Infants (0-12 months)

• Lower threshold for seeking urgent care
• Any fever in babies under 3 months requires immediate medical attention
• Changes in feeding, sleeping, or crying patterns may be significant
• Rapid deterioration is possible in young infants

Toddlers (1-3 years)

• May not be able to communicate symptoms clearly
• Watch for changes in behavior and activity level
• Higher risk for accidents and ingestions
• Febrile seizures are more common in this age group

School-age Children (4+ years)

• Can usually communicate symptoms more clearly
• May hide or minimize symptoms
• Consider school exposure to illnesses
• Sports-related injuries become more common

Non-Urgent Medical Concerns

These situations can typically wait for a routine GP appointment within 24-48 hours:

Common Childhood Illnesses

• Mild Fever: Low-grade fever (under 38.5°C) in children over 3 months, especially if child is otherwise well
• Cold Symptoms: Runny nose, mild cough, congestion without breathing difficulty
• Mild Stomach Upset: Occasional vomiting or diarrhea with good fluid intake
• Rashes: Non-spreading rashes without fever or other concerning symptoms

Routine Health Concerns

• Sleep Issues: Difficulty sleeping, night terrors, or sleep pattern changes
• Behavioral Concerns: Changes in behavior, mood, or development
• Growth and Development: Questions about milestones, growth, or development
• Nutrition Issues: Feeding difficulties, picky eating, or weight concerns

Minor Injuries

• Small Cuts: Minor cuts that can be cleaned and bandaged at home
• Bruises: Normal bruising from typical childhood activities
• Minor Sprains: Mild sprains that respond to rest and ice
• Splinters: Small splinters that can be safely removed at home

Preventive Care

• Routine Check-ups: Regular health assessments and growth monitoring
• Vaccinations: Scheduled immunizations according to the National Immunisation Program
• School Health: School entry health checks and sports physicals
• Chronic Condition Management: Ongoing care for asthma, allergies, or other chronic conditions

When GP Care is Appropriate

• Child is alert, responsive, and able to play or interact normally
• Symptoms are mild and not interfering significantly with daily activities
• No signs of severe illness or distress
• Symptoms can be managed with home care while waiting for appointment
• Routine follow-up for known conditions

Building a Pediatric Healthcare Team

Primary Care Relationships

• Regular GP: Establish relationship with pediatric-friendly general practitioner
• Specialist Care: Identify specialists for any ongoing conditions
• Emergency Contacts: Know how to reach Dr Terry for urgent pediatric care
• After-Hours Care: Understand options for medical care outside business hours

Comprehensive Family Health Services

Dr Terry provides comprehensive healthcare for the whole family, including:

• Men's Health Services: Preventive care, sexual health, and mental health support for fathers
• Trauma & Grief Support: Professional counseling for families dealing with loss or trauma
• 24/7 Emergency Medicine: Round-the-clock medical care for urgent family health needs

Communication with Healthcare Providers

• Medical History: Keep accurate records of illnesses, injuries, and treatments
• Medication Lists: Maintain current list of all medications and supplements
• Allergy Information: Clearly document any known allergies or adverse reactions
• Emergency Plans: Develop action plans for chronic conditions like asthma

Immediate Home Care Measures

Fever Management

• Medication: Paracetamol (15mg/kg every 4-6 hours) or ibuprofen (10mg/kg every 6-8 hours for children over 3 months)
• Comfort Measures: Light clothing, room temperature environment, encourage fluids
• Monitoring: Regular temperature checks and observation of behavior
• When to Seek Help: Fever over 40°C, child appears very unwell, or fever persists despite medication

Vomiting and Diarrhea

• Fluid Replacement: Small, frequent sips of clear fluids or oral rehydration solution
• Diet: BRAT diet (bananas, rice, applesauce, toast) when tolerated
• Rest: Encourage rest and avoid solid foods until vomiting stops
• Monitoring: Watch for signs of dehydration (dry mouth, no tears, decreased urination)

Respiratory Symptoms

• Positioning: Elevate head of bed for easier breathing
• Humidity: Use humidifier or steam from shower to ease congestion
• Hydration: Encourage fluids to thin secretions
• Monitoring: Watch for increased work of breathing or color changes

When Home Care is NOT Appropriate

• Child appears severely ill or distressed
• Symptoms are worsening rapidly
• You're concerned about the child's condition
• Child has underlying medical conditions that increase risk
• Home treatments are not providing relief

Preparing for Medical Consultation

Information to Gather

• Symptom Timeline: When symptoms started and how they've progressed
• Vital Signs: Temperature, breathing rate, and general appearance
• Medications Given: What medications and doses have been given
• Fluid Intake: How much the child has been drinking and urinating
• Medical History: Relevant medical conditions, allergies, and current medications

Questions to Ask Healthcare Provider

• How urgent is my child's condition?
• What warning signs should I watch for?
• What can I do at home to help my child?
• When should I call back or seek further care?
• Are there any medications I should give or avoid?

Safety Measures and Prevention

Home Safety

• Childproofing: Secure cabinets, cover electrical outlets, install safety gates
• Poison Prevention: Store medications and chemicals out of reach, use child-resistant containers
• Burn Prevention: Set water heater to 49°C (120°F), use stove guards, keep hot items away from children
• Choking Prevention: Avoid small objects, cut food into appropriate sizes, supervise eating

Health Maintenance

• Vaccinations: Keep immunizations up to date according to the National Immunisation Program
• Regular Check-ups: Routine pediatric visits for growth monitoring and preventive care
• Dental Care: Regular dental check-ups and good oral hygiene
• Nutrition: Balanced diet appropriate for age and development

Emergency Preparedness

• Emergency Contacts: Keep list of important phone numbers easily accessible
• First Aid Training: Learn basic pediatric first aid and CPR
• Medical Information: Keep updated list of medications, allergies, and medical conditions
• Emergency Kit: Basic first aid supplies and emergency medications

Building a Pediatric Healthcare Team

Primary Care Relationships

• Regular GP: Establish relationship with pediatric-friendly general practitioner
• Specialist Care: Identify specialists for any ongoing conditions
• Emergency Contacts: Know how to reach Dr Terry for urgent pediatric care
• After-Hours Care: Understand options for medical care outside business hours

Communication with Healthcare Providers

• Medical History: Keep accurate records of illnesses, injuries, and treatments
• Medication Lists: Maintain current list of all medications and supplements
• Allergy Information: Clearly document any known allergies or adverse reactions
• Emergency Plans: Develop action plans for chronic conditions like asthma