When to see your pediatrician

By Dr. Ruchi Kaushik
General Pediatrics

Today’s economy probably has you considering and reconsidering every nickel you spend. Pizza night may become less frequent; you may have skipped swimming lessons this year; you searched and searched for the store with the lowest prices for back-to-school supplies. What about doctor visit copays? Knowing when your child should see a doctor versus when to continue the home care you’ve been providing can be very difficult. Here are a few helpful tips for guidance.

  1.  Fever: Unfortunately, even with fever, making the decision can be tough. Any infant less than 3 months of age with a rectal temperature of 100.4 or more should be seen immediately. Children between 3 months and 3 years should be seen relatively quickly for a temperature of more than 102, particularly if there are no other symptoms, as they may have a urinary tract infection. For older children, it is important to remember that the height of the fever is not as concerning as the accompanying symptoms. Most viruses and bacteria will not raise a child’s temperature to more than 105, which is less than the temperature required to cause brain damage. If your child appears happy with a fever, it is probably a virus and less worrisome. Localized pain: If your child can localize an area of pain, such as his ear (an ear infection) or throat (Strep throat), or the fever has lasted longer than 3 days in a child older than 3 years, you should see your doctor.
  2.  Runny nose and/or cough for more than 10-14 days. Of note, green nasal drainage does not necessarily signify the need for antibiotics.
  3.  Vomiting or diarrhea that is persistent or if diarrhea is bloody. Also, if your child  cannot hold down enough liquids to make urine every 6 hours, he may be dehydrated.
  4.  If you have any questions or concerns, you should always feel free to call your pediatrician. Her office will generally try to get you in the same day for an illness.

Emergency room copays are definitely higher than office visit copays; however, here are some symptoms for which you should never compromise a visit to the ER.

  1.  A very ill-appearing child or a child that is lethargic or difficult to arouse.
  2.  Your child is having difficulty breathing, is not breathing, or his lips are blue.
  3.  Seizure.
  4.  Fever with severe headache and/or neck stiffness.
  5.  Fever with a rash of flat red spots or appears to be purple or like blood under the skin.
  6.  An inconsolable infant or child.

Remember, never be afraid to call your pediatrician. A simple phone call may either reassure you, or reconfirm your intuition that it is time to make a trip to her office.

If you need a pediatrician for your child, call The Children’s Hospital of San Antonio at 210.704.4708.

Author: Ruchi Kaushik, MD

Dr. Kaushik received her medical degree at Dayanand Medical College and Hospital in Ludhiana, India, and completed her internship and residency in pediatrics at the Women and Children’s Hospital of Buffalo. She is board certified by the American Board of Pediatrics and currently provides primary care to children with medical complexity.

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