Toddler with fever/vomiting…ER or wait it out?

(May 6, 2010)

Your child gets up in the middle of the night crying. He feels hot to the touch and you quickly take his temperature which is 103 degrees (39.5 Celsius). Should you rush to the ER or wait it out?

Keep in mind that fever is the body’s natural response to an infection. It does not always mean that there is something seriously wrong with your child. Low grade fevers or fevers of 101 to 103(38.4 to 39 Celsius) are usually not serious and you can wait till the morning to contact your doctor. If, however, your toddler has the following symptoms you should seek medical advice.

-    High fevers of 104(40 degrees Celsius) which don’t come down even after medication
-    If your child is listless or lethargic, unresponsive, not making eye contact
-    Highly irritable - cries constantly and is inconsolable
-    If there is high fever, a stiff neck or pain in the back of the neck, headache, vomiting, bright light hurts the child’s eyes. It could be meningitis.

Viral infections (colds, flu, chicken pox etc.) are the most common cause of fever in children. These run their course and do not need antibiotics. Bacterial infections (bladder infections, ear infection, pneumonia etc.) result in fever and are treatable with antibiotics. Treatment, though, can be deferred till the next morning. Teething also causes fever, but this is generally not high.

The most common reason for a toddler to vomit if he has fever is stomach flu. Other reasons include food poisoning, severe coughs and colds, other intestinal illnesses, bladder infections or an intestinal obstruction. It is difficult to differentiate between the first four reasons as the symptoms are all the same. Most importantly, don not panic when your child starts vomiting. Vomiting is usually not dangerous and rarely results in severe dehydration. Keep the fluid intake going and assess the situation periodically.

Do take your child to the ER if:

-    There is persistent vomiting(continues for more than 12 hours)
-    There is blood in the vomit
-    Moderate to severe dehydration occurs
-    You suspect meningitis- vomiting is only one symptom. If your child has the other symptoms given above, rush to the ER.
-    Along with the vomiting there is high fever, the urine smells bad or your child complains of burning with urination. This could be indicative of a kidney infection.

Assess your child’s illness keeping the above points in mind .Above all; go with your gut instinct where your child is concerned.

Submitted by P T on May 6, 2010 at 12:45

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