We have an excellent system for children’s medical care, but sometimes the stumbling block is choosing the first step in accessing that care. Should you call 911? Should you rush to the hospital in your car? Should you call your pediatrician? Maybe you should go to a walk-in medical center? Most of the time my daughter calls me first before deciding what to do, but I’m not giving out my number to the general public, and I’m retired now. So the best I can do is give you some guidelines.

The 911 system is truly miraculous to those of us who remember the time before its existence. The number is easily remembered and covers a multitude of uses. From a medical perspective, it pays to remember that you can get an ambulance right away, and the personnel on that ambulance can help stabilize a patient and inform the hospital about the situation long before they arrive. So it’s not just that they can get to the hospital before you can. They can also provide care before you arrive. If your child has become unconscious or has a respiratory emergency, for example, you can’t drive and care for your child. Even if both parents get in the car, there is no safe way to transport a seriously ill child, and you don’t have an oxygen tank in your car. When you need a trained medical person right away with equipment that you don’t have, 911 is the right choice.

But what if you are worried but not frantic? Something isn’t right. Your child shouldn’t be this drowsy or maybe he’s answering questions vaguely after a head injury. Maybe he can’t walk on his right leg after a fall. Or your toddler can’t stop vomiting and her diaper is dry. Getting to the hospital safely and quickly is the right choice. I have to admit that sometimes making the right choice is difficult. If your child can’t stop coughing and can’t eat or drink, you will want to drive to the hospital because intravenous fluids may be necessary. If your child’s breathing is noisy and labored – pulling in the ribs and pushing out the tummy – you will need the ambulance.

When your child has a fever – and that means a temperature above 100.4 degrees Fahrenheit – you will probably start thinking about making an appointment with your pediatrician. But if your child has developed worrisome symptoms like pain, vomiting, or diarrhea, I urge you to take advantage of your pediatrician’s availability. As much as pediatricians don’t relish late-night calls, they recognize that children’s medical problems don’t happen only during the day, and parents become much more concerned in the evening hours. Also, many pediatric offices contract with trained nurses’ call centers to screen your questions. If the nurses feel you need to speak to the pediatrician, they will connect you to the pediatrician regardless of the hour. The pediatrician generally prefers to have you call before heading off to a walk-in doctor’s office or an emergency room. Sometimes the nighttime trip isn’t necessary, and if a hospital visit is necessary, the doctor may want to call ahead.

There is a last resort. If your mother lives with you, you can always get a quick second opinion. Pediatricians know that grandmothers often have the experience to calm a situation. But if you’re still not sure, give your doctor a call!

May you all stay safe and healthy!

Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit https://centerforpediatricmedct.com.