When should I go to the ER for pediatric care?
Go to the ER for a fever of 100.4°F or higher in a baby under 3 months, trouble breathing, a seizure, dehydration, a non-fading rash, a serious injury, or any child who looks very ill or is getting worse. Milder illnesses in an alert, drinking child can start with telemedicine or your pediatrician.
Making the Call: ER, Urgent Care, or Home
The hardest part of a sick child is deciding where to take them. This page is about that decision — the specific situations that need an ER, and the ones where a lower level of care is reasonable and often faster.
Go to the ER Now
Bring your child to the emergency room without delay for any of these:
- A fever of 100.4°F (38°C) or higher in a baby under 3 months old — this needs same-day emergency evaluation even if the baby looks well.
- Trouble breathing — fast or labored breathing, grunting, flaring nostrils, or ribs pulling in.
- Signs of dehydration — no tears, dry mouth, sunken eyes, no wet diaper in 8 hours, or vomiting that prevents keeping any fluids down.
- A rash that does not fade when pressed, especially with fever.
- A serious head injury with vomiting or confusion, a suspected broken bone, a deep or heavily bleeding wound, or a severe allergic reaction with swelling or breathing trouble.
Call 911 Instead of Driving
If your child is struggling to breathe, has blue or gray lips, is having a seizure, is unresponsive, or has a stiff neck with fever and a non-fading rash, call 911. For a suspected poisoning in a child who is awake and breathing, call Poison Control at 1-800-222-1222 first for guidance.
When Telemedicine, Urgent Care, or Your Pediatrician Is Reasonable
You do not need the ER for every illness. For a child older than 3 months who is alert and still drinking, telemedicine or a pediatrician visit is a sensible first step for typical cold symptoms, a mild cough, a low-grade fever, ear pain, a mild sore throat, a minor rash without other symptoms, or mild diarrhea. Urgent care can handle minor injuries and illnesses during the day. When you are unsure, calling your pediatrician or starting with telemedicine costs little and often points you to the right place.
The Overriding Rule
Guidelines help, but instinct matters. If your child looks very ill, is getting worse, or something feels seriously wrong, choose the ER — that judgment is exactly what emergency physicians are here for.
For a complete guide, see our pediatric care page. Bellaire ER is a walk-in emergency room at 5302 Bellaire Blvd, open 24/7, 365 days a year. Call (713) 660-0001 for guidance.