Some emergency symptoms are either difficult to recognize or are not considered serious by some parents. Most parents will not overlook or underestimate the seriousness of a major burn, major bleeding, choking, a seizure, or a coma. However, if your child has any of the following symptoms, also contact your child’s healthcare provider immediately.
- Sick newborn
If your baby is less than 1 month old and looks or acts sick (vomiting, cough, poor color), or abnormal (poor feeding or excessive sleeping) in any way, the problem could be serious.
- Severe lethargy
Fatigue during an illness is normal, but watch to see if your child stares into space, won’t smile, won’t play, is too weak to cry, is floppy, or is hard to awaken. These are serious symptoms.
- Severe pain
If your child cries when you touch or move him or her, this can be a symptom of meningitis or appendicitis. A child with meningitis also doesn’t want to be held. Constant crying or inability to sleep may mean your child is in severe pain.
- Can’t walk
If your child has learned to walk and then loses the ability to stand or walk, he or she probably has a serious injury to the legs or a problem with balance. If your child walks bent over, holding his belly, he or she probably has a serious problem such as appendicitis.
- Tender abdomen
Press on your child’s belly while he or she is sitting in your lap and looking at a book. You should be able to press an inch or so in with your fingers in all parts of the belly without a problem. It is a problem if your child pushes your hand away or screams. If the belly is also bloated and hard, the problem is even more worrisome.
- Tender testicle or scrotum
Sudden pain in the groin area can be from twisting of the testicle. This requires surgery within 8 hours to save the testicle.
- Hard time breathing
You should check your child’s breathing after you have cleaned out the nose and when he or she is not coughing. If your child has trouble breathing, tight croup, or obvious wheezing, he or she needs to be seen immediately. Other signs of difficulty are a fast breathing, bluish lips, or retractions (pulling in between the ribs).
- Bluish lips
Bluish lips, tongue, or gums (cyanosis) can indicate a reduced amount of oxygen in the bloodstream.
The sudden onset of drooling or spitting, especially associated with trouble swallowing, can mean that your child has a serious infection of the tonsils, throat, or epiglottis (top part of the windpipe).
Dehydration means that your child’s body fluids are low. Dehydration usually follows severe vomiting and/or diarrhea. Suspect dehydration if your child has not urinated in 8 hours (more than 12 hours if over 1 year old); crying produces no tears; the inside of the mouth is dry rather than moist; or the soft spot in the skull is sunken. Dehydrated children are also tired and weak. If your child is alert and active but not making much urine, he is not dehydrated. Dehydration requires immediate fluid replacement by mouth or intravenously.
- Bulging soft spot
If the soft spot in the baby’s head is tense and bulging, the brain is under pressure.
- Stiff neck
To test for a stiff neck, lay your child down, then lift his head until the chin touches the middle of the chest. If he or she is resistant, place a toy or other object of interest on the belly so he will have to look down to see it. Older children can simply be asked to look at their belly button. A stiff neck can be an early sign of meningitis.
- Injured neck
Talk to your child’s healthcare provider about any neck injury, regardless of the symptoms. There is a risk of damage to the spinal cord with neck injuries.
- Purple spots or dots
Children often get bumps and bruises, but if you notice any unexplained purple or blood-red spots or dots on the skin it could be a sign of a serious bloodstream infection.
- Fever over 105°F (40.6°C)
All the preceding symptoms are stronger indicators of serious illness than the level of fever. All of them can occur with low fevers as well as high ones. Fevers alone are serious only when the temperature rises above 105°F (40.6°C). In infants a rectal temperature less than 96.8°F (36°C) can also be serious.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick”, American Academy of Pediatrics Books. Published by RelayHealth.
Last modified: 2009-06-19
Last reviewed: 2011-06-06 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Pediatric Advisor 2011.4 Index
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