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Symptom Decision Chart for Parents

Symptom Decision Chart

When kids are sick or hurt parents aren't always sure what to do. Use this chart as a guide to decide how urgent the issue is and what to do until your child needs to be seen. When possible, it is best to use our office for most healthcare needs. This cuts your costs -- ER visits are more expensive -- and it helps provide comprehensive care. Whenever an urgent care or ER is recommended, we prefer a pediatric specific location if possible. 

Problem Timeframe to be seen At home treatment Tips
  • Less than 2 months - call immediately if temperature over 100.5F,
  • Over 2 months and vaccinated - call during business hours unless there are other concerning symptoms.
  • Push fluids, monitor for pain and other symptoms.
  • Fever is often the first sign of illness so coming in immediately often is less helpful because not all symptoms have developed.
  • After about 102F or if there is discomfort you can use acetaminophen (if over 2 months) or ibuprofen (if over 6 months).
  • For more, see our Fever page.
  • Under 2 months of age or incompletely immunized – be seen ASAP at our office or an ER.
  • If over 2 months and vaccinated, your child should be seen in the medical home if symptoms are concerning or by day 3-5 of fever.
  • Most viruses last 3-5 days so there is no specific treatment.
  • The height of the fever doesn’t matter as much as how a child acts otherwise. There is no magic temperature we worry most about.
 Cough and cold
  • If difficulty breathing - be seen immediately in our office or an ER.
  • If able to drink and talk comfortably (age appropriate), call during normal office hours.
  • Warm drinks, cough drops (in school aged children - they're a choking risk in younger kids), honey in children over 1 year of age, humidified air.
  • If your child has asthma, follow the Asthma Action Plan.
  • See also our cough and cold page. 
  • If difficulty breathing (>60 breaths/minute), sucking in of ribs, looking scared – to our office or an urgent care immediately.
  • Most coughs last 2-3 weeks but are caused by a virus so not all need to be seen unless there is a concern for difficulty breathing, pneumonia, or whooping cough.
 Earache During normal business hours
  • Treat pain with a pain reliever, such as acetaminophen or ibuprofen.
  • Olive oil in the ear may help if there are no tubes or hole in the eardrum.
  • See also ear pain page.
  • Ear infections are best addressed in your child’s medical home so we can keep track of frequency and progression.
  • Ear pain is not an emergency unless the ear is sticking out from its normal position.
  • Most ear infections are from a virus and do not need antibiotic, and even if an antibiotic is used, pain control is most important. 
 Sore throat 1-2 days unless difficulty swallowing or breathing - then immediate
  • Pain relievers, cold or warm drinks, throat lozenge in school aged children.
  • See also our strep throat page.
  • Strep testing does not need to be done immediately.
  • No sore throat should be given antibiotics before testing is done.
  • It is okay to wait a day or two if your child can swallow and breathe comfortably. 
 Vomiting & diarrhea
  • Immediately call if signs of dehydration or if severe pain.
  • To ER if green vomit.
  • Call during business hours otherwise.
Clear liquids (Pedialyte, water, sports drinks, watered down apple juice) or breastmilk. 
  • Offer small volumes (1/2 - 1 tsp) every 10 minutes until larger amounts are tolerated.
  • Signs of dehydration: no tears if crying, dry inside mouth, no urine in 4-6 hrs.
  • For more, see our vomiting and diarrhea page.
 Abdominal pain
  • Severe pain- call our office or doctor on call.
  • If chronic, vague or mild pain – call during office hours.
Varies based on symptoms.
  • Most common causes of abdominal pain in childre are not serious, including constipation and stomach viruses.
  • Appendicitis often starts in the mid-abdomen and moves to the right lower abdomen.
  • Bloody stools, severe pain, yellow or green vomit, and dehydration are reasons to be seen immediately.
  • If your child cannot get up and walk normally, he should go to the ER.
  • Chronic abdominal pain that isn't suddenly worse should wait for an appointment with the usual doctor.
 Cuts & Scrapes
  • Immediate if needing to be repaired.
  • Within 24 hrs if a tetanus shot is needed.
  • Call for advice.
  • Clean area.
  • Hold pressure if bleeding. 
  • Apply antibiotic ointment and a bandage.
  • Apply ice pack if needed for bleeding or swelling.
  • If skin gapes open or if bleeding won’t stop, it may need to be repaired. 
  • Our office can do simple laceration repairs with glue, stitches, or staples.
  • We can see your child’s vaccine record to see if a tetanus shot is needed.
  • After hours go to an ER.
  • Wounds must be repaired within a few hours or the risk of infection is too high to close it.
  • Look on your portal to see the last date of Dtap or Tdap (tetanus shots). It must have been within the past 5 years or another will be needed for significant wounds.
 Possible broken bone
  • If angulated or skin broken: go to ER.
  • If able to splint it, splint until office hours.
  • Pain control with acetaminophen.
  • Keep area splinted for comfort. 
  • If it is angulated or the skin is broken, do not give your child anything to eat or drink until you get to the ER. Ask if it's okay. If surgery is needed, eating or drinking will delay fixing it.
  • If the bone is angulated or if the skin is broken in the area of a broken bone, it needs to be treated as soon as possible.
  • Most simple fractures are not emergent and can be first assessed in the office. 
  • We do not do x-rays in our office, but can have them done locally.
 Urinary sympotms
  • Less than 3 months or any age with severe symptoms: immediately
  • Over 3 months with mild to moderate symptoms: during office hours.
  • Push fluids.
  • Use pain reliever if needed.
  • Monitor for associated symptoms.
  • If blood in the urine, temperature >102F, vomiting, puffy eyes, swollen feet, or extreme pain be seen immediately in the medical home or an ER.
  • If overall well appearing and no vomiting or fever over 102F, you may wait until our office opens. 
 Head injury
  • Call 911 if unconsious, seizure activity, or not acting normally.
  • Call our office or the doctor on call for other head injuries.
Watch closely for the first 24 hrs after a head injury.  See our concussion page for more information.
 Animal bite
  • Get medical help immediately for any animal bite that is more than a superficial scratch or if the animal was a wild animal or stray, regardless of the severity of the injury.
  • Call our office or the on call provider if you're unsure.
Hold pressure to stop any bleeding and wash the area with soap and water. 
  • Puncture wounds will need to be evaluated and treated in our office, urgent care, or emergency room.
  • Wounds with significant bleeding or tearing of the skin should be seen in an ER.
  • If you know the owner of the animal, find out if the animal's shots are up to date.
  • Call the local health department or animal control if it is a stray, unknown, or wild animal.

Find health information quickly in our parent toolkit.

Illnesses & Symptoms