Bringing a Child to the Emergency Room at Night

If your child is struggling to breathe, unresponsive, having a seizure, or has skin that looks blue, call 911. Do not drive them.

We are not a pediatric emergency room, and we treat children every day.

Both halves of that sentence matter, and leaving either one out would mislead you. This page is what each half means in practice at two in the morning.

What the first half means

A pediatric emergency room is a department built entirely around children — paediatric emergency specialists, paediatric intensive care, the full range of subspecialties in the building. Ours are not that, and a website that implied otherwise would be setting you up for a bad surprise at the worst hour of your life.

What the second half means

Children come through our doors constantly, and our emergency rooms are equipped and staffed to assess and stabilise a child. CT, X-ray and a full laboratory are in the building, staffed around the clock, so the question you arrived with usually gets answered during the visit.

For a great many of the reasons a child ends up in an emergency room at night — a fever that has climbed, a fall, a cut, croup, an asthma flare, vomiting that will not stop, something swallowed, a rash nobody can explain — that is the right door, and the nearest one is better than the further one.

And where a child needs a specialist level of paediatric care, we arrange the transfer rather than keep them. That decision gets made on evidence, after assessment, by people who have already started treatment.

When not to drive at all

Call 911 rather than driving if your child has any of these. The National Library of Medicine’s guidance on recognising medical emergencies names them in a child:

• Skin that looks blue
• A fever with a stiff neck
• Bleeding you cannot control
• A child who cannot stand

Add the ones that are emergencies at any age: difficulty breathing, a seizure, unresponsiveness, or a rash of small dark red or purple spots that do not fade when you press on them.

And anything where you genuinely believe your child could be in danger. You do not need to be right.

What to bring, and what to say

Bring: any medication they take, their immunisation record if it is to hand, and the name of their paediatric practice.

Say, in the first sentence: their age, and the worst symptom. Parents are polite and lead with context — sorry, it has been a long night, it is probably nothing. Lead with “she is four months old and her temperature is 101” instead. It changes what happens in the next thirty seconds.

Say how they normally are, too. You are the only person in the building who knows what this child looks like when they are well, and “he is not himself” from a parent is clinical information, not an apology.

A note on fever, because it is the most common reason

The threshold depends on age, and for the youngest babies it is low: under three months old, a rectal temperature of 100.4°F (38°C) or higher warrants immediate contact, even if the baby seems well. The full age bands and which thermometer to use are in the fever post.

This page gives no doses, deliberately. Fever medicine for a child is dosed by weight rather than by age and depends on the specific product you have. If you are unsure, call and ask — and if you think a child has had too much of anything, Poison Control answers at any hour on 1-800-222-1222.

During the day, a paediatric practice is usually the better door

Not because an emergency room would turn you away — it would not — but because a practice that knows your child starts further along. They know the growth curve, when the last ear infection was, what is going round.

Mercy Grace Pediatrics & Primary Care in Gilbert is built for children specifically.

And the reason this paragraph is about doors rather than about whether your child is sick enough: that second question is not one you should be carrying. If it is the middle of the night, or something is getting worse while you watch it, come in.

Questions people actually ask

Will you see a newborn? Yes. And for a fever in a baby under three months, do not wait for morning.

Do you have a paediatrician on site? Our emergency rooms are staffed to assess and stabilise children, and they are not paediatric emergency departments. Where a child needs specialist paediatric care, we arrange the transfer.

Can both parents come in? Ask at the desk — we would rather you asked than assumed either way.

Will my child be scared? Probably a bit, and it helps more than you would expect if you are the one narrating what is happening. Bring the blanket or the toy.

I think I am overreacting. “I am probably overreacting” is a sentence we hear constantly and it is almost never true. Bring them in.

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If your child is struggling to breathe, unresponsive, having a seizure, or has blue-looking skin, call 911. Otherwise both of our emergency rooms are open 24 hours a day, every day of the year — walk in, no appointment and no referral. Find your nearest location →

Related reading: when to go to the emergency room for a fever in a baby · primary care and pediatrics across our network

Sources

3. Recognizing medical emergencies — MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine. https://medlineplus.gov/ency/article/001927.htm

This article is general information, not a diagnosis, and it cannot account for your child’s history or medications. It gives no doses. If you are unsure, come in — this list is not exhaustive and you are not expected to diagnose your child. If it might be an emergency, treat it as one and call 911.