MADERA, Calif. – As respiratory viruses like respiratory syncytial virus (RSV) and influenza begin to pick up during the winter months, parents often wonder when to take a sick child to the emergency department and when it’s safe to manage symptoms at home.
Dr. Brent Feudale, a pediatric emergency physician with Valley Children’s Healthcare, said most cases can be treated at home with supportive care.
“Traditionally, viral infections present with low-grade fever, cough, congestion and runny nose,” Dr. Feudale said. “There’s no particular treatment to fix this, and antibiotics or lab testing usually aren’t required.”
Instead, he recommends treating fever with acetaminophen or ibuprofen – avoiding ibuprofen in children under 6 months – and making sure the child stays hydrated.
“If you have concerns, the first step I always encourage is evaluation by your primary care doctor,” Dr. Feudale said. “A local urgent care can also evaluate, and then they can dictate if they think it’s concerning enough to head to the emergency department.”
Signs That Require Emergency Care
That being said, there are signs that parents should look out for that would necessitate a visit to the emergency department. Dr. Feudale says parents should seek emergency care if a young child shows signs of respiratory distress, including:
- Trouble breathing, such as fast breathing, belly breathing or ribs visibly moving with each breath.
- Nasal flaring.
- Blue or dusky skin color.
- Difficulty feeding in infants.
- Inability to drink liquids in older children.
- Persistent lethargy even after fever treatment.
“These would all be reasons to come to the emergency department,” he said. “But a low-grade fever, congestion and cough without increased work of breathing is not an emergency.”
Fever Alone Is Not an Emergency
Fevers themselves often don’t automatically require an ER visit, Dr. Feudale said. What matters most is how the child responds after fever treatment.
“If you treat the fever and the child feels better and is drinking, that’s reassuring,” he said. “If you treat the fever and they’re still lethargic or not drinking, then the emergency department might not be a bad place to start.”
Feudale said fever is a natural response to infection and most viral illnesses last three to seven days.
“Please reach out to your primary care doctor first and give it some time at home before utilizing the emergency department,” he said. “Our wait times are extremely long, so these steps can save time and stress.”
Additionally, Dr. Feudale says that families should not expect to be able to visit the emergency department just for a viral swabbing to test for RSV – instead, the best way to get tested is to contact your primary care doctor.
For more information about keeping infants safe from RSV, click here.
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