How do you decide when to call or go to the pedi?

[doberbrat]

dd2 (14 mo) is sick again. Has a nasty cold and her molars are coming in. Fever's varied between 101 and 103, lots of wheezing/congestion, breathing is a little fast but no retractions and her color is good. Behaviorally, she's 'off' but not acting like she's horribly sick iykwim. We've been using a neb every 4 hours, hot steamy baths, garlic on her feet and ginger on her chest.

Today, around 4pm, I realized I probably should have taken her to urgent care. But at that point it would be an ER visit and that just seemed silly.

But now I'm realizing that I always err on the side of not calling and maybe I should have?

So how do you decide?

[jenstring95]

Can you call your doctor and have the answering service get a doctor or nurse to call you back? We went through this exact issue with 5yo DS last weekend. He had coughing, a low grade temp (highest it got was 100.4), rapid, shallow breaths and some wheezing. We called them Sunday afternoon and they said to call back if he got worse, particularly if his ribs started sinking in when he breathed. Sunday night he fell asleep at 8pm for 30-40 minutes and then woke up restless, unable to get cool enough (even though Motrin brought his temp down to normal), and his ribs were sinking in with each breath. We called back, and they advised us to take him to the ER. We asked at triage if we should have brought him, and they said yes. It ended up that he had pneumonia, but at least we caught it very early. The point is, make sure you watch your DD overnight, as I think with pneumonia (not that I would have any clue if that's what your DD has; I am no doctor!) they can sometimes go downhill very quickly. In any event, I think it would warrant a call if you can. Good luck! I hope you all get some sleep!

[lalasmama]

I openly admit that the advice nurse knows me by name at La's doctor. But, I adore her, and she usually is able to calm my fears and tell me not to worry (or to come in, if my fears need face time).

How do I decide when to call? A few different things. First and foremost, when I experience a brain fart regarding my previous training (I've done peds advice line before, for about 2 years). More of my calls to the nurse start with "I should know this, but mommy brain has taken over rational brain, so remind me about the steps in xyz, please." Second is based on her acting "sick"--is she still running around like a wild banshee, or has she decided Perry Mason on the TV is entertaining enough. If she's sick enough that tylenol/motrin and a Disney flick don't fix it, I call. However, she's rarely sick, so I still feel "new mommy" when she's ill :)

That being said, I always also remind myself of my first winter with my first foster child. I had worked in pediatrics for 2 years at that point, and I was *positive* that the baby (18 months) had pneumonia or such, and that she would need to be admitted, and so I rushed her to the children's ER. The next day, my coworker got the report from the ER, and teased me sweetly. Baby was in the middle of her first cold-- no pneumonia or anything else. Lesson learned: Had I called the advice nurse, she would have told me that I didn't need to rush Baby to the ER at 2am... So, when I call the advice nurse, I remember that it's better than rushing into the ER and being told she just has the sniffles.

And if we're having a bad week and I've called the advice line multiple times, I apologize first, and thank her before she's done anything, because I'm a worrywart :)

[kerridean]

Sadly mine need to be on death's door before I call. We are military and have basically NO access to health care at this point.

[khalloc]

I've never gone to the ER or urgent care type place. I call the doc IF I think they might actually give mess or if she might be able to do something to help. Ds has asthma so I am more likely to call for him if he is having trouble breathing or coughing a lot and she hasn't seen him in a long time for his asthma.

I call if I think they mint have an ear infection.

[hellokitty]

If we're not sure, we just call the ped's office and talk to the nurse. She is pretty good at weeding out what needs to be seen by the doc, and what doesn't. Like, my kids had that yucky flu a few wks ago and their fevers would respond to meds, but lasted for almost a wk. We finally called and spoke to the nurse, but she just reassured us it was probably viral and to just wait it out. The kids are all ok now, w/o any extra meds, etc., so everything turned out fine.