During business hours, we have multiple doctors and nurses available to answer any question you may have about your child’s health. Whether it’s something you feel is silly or an issue you’re really worried about, we’re always happy to give you advice. That’s part of our job.
But as often happens with children, something might pop up in the middle of the night or over the weekend and you have to decide what to do on your own. The size of the worry depends on the age of the child. We always worry more with very small babies compared to teenagers, because their bodies are different and we have to balance that with other symptoms they may have.
We have a really great system at Cook Children’s for folks with children who are seen by our pediatricians and have questions when our offices are not open. It is called the Triage Nurse Line and it is staffed by individuals trained to ask about warning signs and symptoms. You can reach the Triage Nurse line by calling your pediatrician’s office after hours. They can help you determine if your child needs to be seen immediately, or offer helpful tips so a family can get through the night or weekend. These nurses are very experienced and are good at recognizing specific issues that help determine if it’s time for a trip to the emergency room, or it’s something that can be managed at home.
There are times when you should definitely call your child’s doctor. If a baby under 2 months old has a fever of 100.4 or higher, that’s always reason for concern. It may seem like they aren’t very sick, but when they are that young it’s hard to tell if it’s something serious. If your baby is 2 months old or younger and has a fever of 100.4 or higher, give us a call or go straight to the emergency room.
In older kids, there’s a little bit more wiggle room. If your child is a toddler or older and they have a fever, but they otherwise seem okay, you can probably keep an eye on them at home. However, there is cause for concern if they have fever and seem like they are breathing very fast or breathing hard, if they have lots of vomiting or diarrhea and you are worried about them becoming dehydrated, or if they are in significant pain that isn’t going away.
Injuries can occur day or night. Examples of times to call our nurse triage line are:
- Your child has a cut and you’re not sure he or she needs stitches
- Your child has fallen and you think they may have broken a bone
- Your child is not walking the way the normally do or they have a limp
The triage nurses are well-equipped to ask you about the injury and help you decide if you can manage it at home, or if it should be evaluated at an emergency room or urgent care.
There are minor illnesses that can wait until your doctor is in the office. For instance, this time of year many kids have a cold. Their nose is stuffy, they have a cough and maybe even a fever, but they’re still acting ok and eating and drinking normally. But you can tell when your child just isn’t feeling 100 percent. In those cases, it should be fine to wait until the next day to call your doctor’s office to see if your child needs to come in to make sure nothing else is happening.
Another common question centers on the little tornadoes in the family … toddlers. Toddlers are still learning how to walk and they usually manage to hurt themselves. They are especially prone to bumping their heads. Normally when they fall and hit their head, they cry right away and run off. In this case, it’s not necessarily something you have to be too concerned about.
You should call 911 for any potentially serious head injury. Signs of a serious head injury are:
- The child is unconscious or unresponsive
- Your child is not responding to you normally
- You can’t wake your child up
- Your child looks at you like they aren’t sure who you are
- If they are old enough to talk and they aren’t using normal sentences or they aren’t making sense
Additionally, if a child gets into medicine or you think they’ve swallowed something but the child is alert, then you should call poison control at 1-800-222-1222. If the child has a change in mental state, call 911.
Hopefully, you won’t ever have to use any of these phone numbers. But in reality, you probably will. Just know that when you do, we will be there ready to help you take care of your child.
- Head injuries instruction sheet
- Poison instruction sheet
- Is it the cold or the flu?
- First aid safety information
- Newborn information
Catherine Nicholas, M.D., is located at 1129 Sixth Avenue, Fort Worth, Texas 76104. To make an appointment with her or her partner, call 817-336-4896 or click here.