When to Call the Doctor, PAMF

Parents often wish they had a crystal ball to help them decide when their sick child needs to go to a doctor. Is the sore arm after a fall really broken? Is the rising fever a sign of serious illness?

Joseph J. Schwartz, M.D., a family medicine doctor at the Palo Alto Medical Foundation in Fremont says, “As a fellow parent and physician, I think that one of the most difficult parenting decisions to make is when to contact your child’s doctor, as you have to decide the level of urgency and the source of your information.”

During well child visits, discuss potential future situations with your child’s doctor that merit an email or an immediate phone call, recommends Dr. Schwartz. “Beyond that,” he says, “the most important advice is to trust your instincts — if your child looks really sick to you then act immediately.”

Dr. Schwartz offers these specific guidelines on when you should seek medical help for your child.

Call you doctor during regular office hours if your child:

  • Has a fever higher than 101.5 F, especially if the child is younger than 2 years old
  • Is unable to keep any fluids down and is no longer making tears
  • Is unusually tired and lethargic
  • Has a cold and is constantly crying, irritable and difficult to console

Call your doctor immediately if your baby younger than 2 months of age:

  • Has a fever of 100.4 F rectally
  • Is vomiting (not spitting up)
  • Is very irritable, lethargic or is skipping feedings
  • Has infected-looking skin around the umbilical stump (red and warm to the touch or has a bad odor)

Call your doctor immediately for medical advice if your child of any age:

  • Is constantly crying, irritable, inconsolable and behaving differently than usual
  • Is having any difficulty swallowing and is drooling more than usual
  • Is difficult to arouse, confused or delirious
  • Has a stiff neck or headache and fever over 101.5 F
  • Has purple or red spots on the skin that are large or pinpoint in size and do not fade with pressure
  • Has difficulty breathing (unless it is due to a stuffy nose)

Go to the nearest emergency room or call 911 if your child:

  • Stops breathing. Call 911 and begin CPR immediately
  • Loses consciousness at any time
  • Experiences a seizure (unless the child has a known seizure disorder)
  • Has severe bleeding that does not stop or slow down after five minutes of direct pressure
  • Suffers a head injury that causes loss of consciousness or exposes or deforms the skull
  • Has difficulty breathing or gasping aspirations
  • Exhibits sudden changes in the eyes (like crossed eyes, droopy eyelids or difficulty using the eyes)
  • Suffers an injury that causes paralysis or profound weakness in any part of the body

Joseph J. Schwartz, M.D., is a board-certified family medicine physician at the Palo Alto Medical Foundation (PAMF) in Fremont. Advice is not intended to take the place of an exam or diagnosis by a physician.

 PAMF background: The Palo Alto Medical Foundation for Health Care, Research and Education (PAMF) is a not-for-profit health care organization dedicated to enhancing the health of people in our communities. This includes more than 800,000 patients and countless community members across Alameda, San Mateo, Santa Clara and Santa Cruz counties