For parents, few things are more stressful than seeing their child in pain or distress. Whether it’s a high fever in the middle of the night, a sudden rash or a bump on the head, deciding where to turn for help—the emergency department (ED), urgent care or their physician's office—can feel overwhelming. Many parents struggle with this choice, often second-guessing their instincts out of fear of overreacting or waiting too long.
But knowing when and where to seek medical care isn’t just about peace of mind; it can make a real difference in your child’s health. Prompt decisions can prevent complications, reduce unnecessary hospital visits and ensure that your child gets the right care at the right time.
The AMA’s What Doctors Wish Patients Knew™ series gives physicians a platform to share what they want patients to understand about today’s health care headlines.
In this installment, William “Billy” Lennarz, MD, took time to discuss when to go to the emergency department, urgent care or schedule an appointment with your child’s pediatrician.
Dr. Lennarz is in a great position to know. He is a pediatric emergency physician and system chair for pediatrics at Ochsner Children’s in New Orleans. Ochsner Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Try your pediatrician first
“If your child develops a new illness or sustains a minor injury, your child’s primary care physician should always be your first point of contact, often through a phone call or message,” said Dr. Lennarz. “Urgent-care clinics can serve as an extension of your pediatrician’s office, offering after-hours care for minor illnesses or injuries.”
“However, it’s important to keep in mind that not all urgent-care centers have staff trained specifically in pediatric care,” he said. “When in doubt, it’s best to consult your pediatrician or family physician first—except in the case of life-threatening emergencies—to determine the most appropriate place to seek care.”
“If your community has a dedicated pediatric emergency department, it is the ideal choice for more serious symptoms or injuries, such as significant cuts, broken bones, seizures, fevers in newborns or infants, severe abdominal pain or difficulty breathing” Dr. Lennarz explained. “These facilities are specially equipped and staffed by professionals providing the highest level of care specifically for children.
These symptoms require emergency care
For “any fever over 100.4º F in a baby under 3 months old,” parents should seek emergency department care for their child, said Dr. Lennarz. It is also important to seek emergency department care for “head injuries followed by repeated vomiting, somnolence—excessive sleepiness or drowsiness—or changes in vision, speech or balance.”
Other symptoms best addressed in an emergency department include “cough or trouble breathing, especially if your child seems pale or gray or is ‘sucking in’ their ribs or neck with every breath,” he said. “Or if they are breathing faster than normal, even when resting.”
Emergency care is also needed with “seizures or convulsions. If your child is on seizure medicine, always remember to take the medicine with you and know when the last dose was given,” Dr. Lennarz said. “Ingestion of any nonfood substance or medication also requires emergency attention which can start with a phone call to your poison control center.
“Every state has a regional poison-control center that can help you determine if you need to go to the pediatric emergency department,” he added. “If you do have to go to the ER, be sure to take the bottle of the ingested medicine or substance with you.”
Additionally, go to the emergency department for “injury where the arm or leg seems angled or deformed or there is an area of marked swelling,” Dr. Lennarz advised.
Lastly, seek emergency attention for “vomiting or diarrhea that has gone on long enough that your child has dry skin, sticky lips or tongue, and decreased urination from normal. These are all signs of significant dehydration.”
Use urgent care for certain cases
“A quick call to your pediatrician or family physician can help you decide if a visit to an urgent-care center is a good option for your child,” said Dr. Lennarz. Such settings “can be a very practical choice for certain nonlife-threatening situations when your pediatrician or family physician isn’t available, and the emergency department isn’t necessary.”
“For example, if your child has a mild fever, a sore throat, an earache or cold symptoms that you’re concerned about, urgent care can provide a timely evaluation,” he explained. “They’re also a great option for minor injuries such as small cuts that may need stitches, minor burns, sprains or simple fractures that aren’t causing intense pain or significant deformity.
“That said, it’s important to confirm that the urgent-care center you choose is equipped to treat children and staffed by professionals experienced in pediatric care,” Dr. Lennarz added. “Some urgent-care clinics now have personnel specifically trained to work with kids, ensuring your child gets the most appropriate treatment in a reassuring environment.”
Pediatric EDs are designed for kids
“Pediatric emergency departments, like at Ochsner Children’s Hospital, are uniquely designed to meet the specific needs of children, providing a level of specialized care that general or adult emergency departments cannot always offer,” said Dr. Lennarz. “The department is staffed by nurses, doctors, technicians, X-ray technicians, pharmacists, child-life specialists and others who understand how illnesses and injuries present differently in children compared to adults.
“They have expertise in treating newborns, toddlers and teens, ensuring care is tailored to a child’s age, size and developmental stage,” he added, noting “a key difference lies in the equipment. Pediatric emergency departments are equipped with child-sized tools and supplies—such as smaller IVs—appropriately scaled imaging devices, and child-specific medications. This ensures not only comfort but also accuracy and safety in treating young patients.”
“Another critical aspect is communication,” Dr. Lennarz said. “Pediatric emergency teams are skilled in explaining conditions and procedures in ways that children and parents can easily understand, creating a sense of trust and reassurance.”
But not all areas have a pediatric emergency department. In those instances, an emergency department can still provide high quality care for pediatric patients.
Watch for these age-specific signs
“Generally, if a child is younger than 4–6 months old, you should have a lower threshold for going to a pediatric ER and having them checked out,” said Dr. Lennarz. “In infants, watch for difficulty feeding, persistent crying that can't be soothed, labored breathing or a lack of wet diapers.”
“For toddlers, look out for signs such as lethargy, high fevers that don't respond to treatment, difficulty walking or breathing issues,” he said. Meanwhile, “older children may show warning signs such as severe headaches, chest pain, confusion or rapid onset of weakness.”
Be prepared for the ED or urgent care
“Preparation can make a big difference when visiting urgent care or the emergency department with your child,” said Dr. Lennarz. “Know what, if any, chronic illness your child might have, their immunization status, their medications and know about any reason they have been admitted to the hospital in the past.”
Additionally, “pack comfort items for your child—such as a favorite toy or blanket—to help reduce anxiety,” he said. “And many times, if your child is being seen for abdominal pain, a possible broken bone or anything else that might require anesthesia, it is best to not give your child food or liquid by mouth until the emergency department staff gives the okay.”
“Staying calm and organized will help ensure your child gets the best care quickly and efficiently,” Dr. Lennarz said.
Trust your instincts as a parent
“You know your child better than anyone,” said Dr. Lennarz. “If something feels off, or if your child’s condition worsens rapidly, seek prompt medical attention. Even if you aren’t certain whether the situation is severe.”
“No matter the age, if a behavior or symptom seems unusual for your child, trust your instincts and seek medical advice promptly,” he said.
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When deciding, consider availability
“If your pediatrician or family physician is available and the situation isn’t urgent,” said Dr. Lennarz, “call their office first” before deciding on an emergency department or urgent care visit.
“Many pediatricians and family physicians offer same-day appointments or telehealth options for minor illnesses, saving you an unnecessary trip outside your home,” he added.
Know when to call 911
“For emergencies such as unconsciousness, severe head or neck injuries, uncontrolled bleeding, or difficulty breathing,” said Dr. Lennarz, “call for an ambulance instead of driving to a care facility.”
Emergency medical services “professionals can stabilize your child during the trip and alert the emergency staff in advance,” he added.
If unsure, contact your doctor
“If you’re unsure about the best course of action, reach out to your pediatrician for guidance,” said Dr. Lennarz. “However, in cases of clear and significant concerns, such as severe injuries, deep lacerations, unusual pallor, difficulty breathing, seizures, persistent or green-colored vomiting, bloody or prolonged diarrhea, or noticeable changes in your child’s mental state, seek immediate care.
“For these situations, it’s crucial to go directly to an emergency room, either by personal vehicle or ambulance, to ensure your child receives the appropriate care as quickly as possible,” he added.
