When to Call the Pediatrician

It happened to me last weekend. My 11-year-old had a pea-sized bump on his shin. I panicked: What if it’s a blood clot?

And then I did what every other parent does, debated whether it warranted an after-hours call to the pediatrician. Thank goodness I have a pediatrician who encourages patients to call.

“It’s my job to be available to any parent who has a concern,” explains Dr. Richard Weinstein, one of four pediatricians in his Chicago and Northbrook-based practice. “Parents should have a close relationship with their pediatrician. You need that rapport, that history, to treat your patients effectively. In fact, being available actually cuts down on the number of calls I receive.”

But aside from the freak condition, how do you know when to call?

Sure there are the classic emergencies that any novice parent can identify:

  • Head trauma
  • Persistent vomiting and diarrhea with loss of fluids
  • High fever
  • Respiratory distress
  • Severe abdominal pain

But even in these instances, there is some ambiguity. A child with a high fever who is active might be less of a concern than a listless child with a low fever. A midnight onset of croup could be abated with a steam shower and calmed nerves.

According to Dr. Lori Walsh, a pediatrician with Children’s Memorial Hospital affiliate Glenbrook Pediatrics, there’s no master list on when to call. “Any time you have a concern that hits a threshold or you’re not sure of your decision, you should reach out to your pediatrician. But if it’s life threatening, always call 911 first.”

In non-acute situations, Dr. Walsh recommends using KidsDoc, an iPhone App listed on the American Academy of Pediatrics website, healthykids.org. “I’ve found this to be a trusted, ready resource when you need medical advice.”

Both pediatricians, however, caution against relying on minute clinics or the emergency room as a convenience. Certainly in acute situations, parents should always seek immediate medical attention. But sometimes waiting until the doctor’s office opens in the morning is the wiser option. “Patients are better off getting the attention of a doctor who knows their medical history and is available for follow-up care,” explains Dr. Weinstein.

“Whatever you do, don’t go to a pharmacy clinic for your child’s physical, even if the medical form is due tomorrow,” Dr. Walsh warns. “Knowing a patient’s history keeps them healthy and safe in the long term.”

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