Winter is coming… and so are the various illnesses! Coughs, colds, vomiting, diarrhea – you name it, it’s out there. In fact, many of you may be experiencing one or more of these in your own home. Often, the most difficult thing for parents is knowing whether to wait it out or get it checked out. Another common concern is whether an illness requires antibiotics or not.
In general, it is okay to wait 24 – 72 hours before rushing to the doctor. This rule of thumb stands if your child is able to take fluids, is urinating every 8 hours, and still has periods of alertness or brief playfulness. Times when waiting would not be appropriate include children less than 3 months of age, children who cannot maintain their hydration, and children with underlying co-morbid conditions (such as diabetes, asthma, immunodeficiency, etc.). That being said, you know your own child best, and we are always happy to evaluate a child about whom a parent is concerned.
- Viral illnesses versus bacterial illnesses
Viral illnesses are caused by a group of organisms that do not respond to antibiotics. A bacterial illness is caused by a group of organisms (mainly bacteria) that respond to antibiotics. The majority of childhood illnesses are, in fact, viral. The tricky part is figuring out which is which.
In children, viruses and bacterial illnesses can cause similar symptoms. Some of the most common symptoms include fever, cough, runny nose, and sore throat. Many parents may feel that a trip to the doctor was not successful if an antibiotic was not prescribed. As physicians, many of whom are parents as well, we certainly understand the desire for a quick resolution to an illness for both our children’s sake and our sake.
Despite this, prescribing antibiotics inappropriately can cause potential harm to your child and can create antibiotic resistance in the surrounding community. Antibiotics do their job well because they kill off bacteria. Unfortunately, the antibiotic is not always discerning enough to kill off only the bad bacteria. Therefore, children can get intestinal upset, be more susceptible to harmful intestinal bacterial overgrowth, get yeast (vaginal and skin) infections, and overall be less susceptible to that particular antibiotic next time it is prescribed appropriately. Examples of some illnesses that cannot be treated with antibiotics because they are viruses include the common cold, flu, and mono.
- RSV – a quick note
Many of you may be hearing the buzzword “RSV” in the community right now. Respiratory syncytial virus (RSV) is a common respiratory virus that acts like the common cold in older children and older adults, but can lead to more serious respiratory effects in babies and young children.
We thought it was important to touch upon this topic in our blog because of the prevalence, but also the lack of understanding of this virus. RSV is the name of the actual virus that causes the symptoms of the lungs and respiratory tract. Because there is no medication for RSV, the treatment consists of supportive care and frequent monitoring. In extreme cases, some young children may require hospitalization for respiratory support (such as oxygen), but most often, children recover from their symptoms on their own. If you have any questions or concerns regarding this virus, please do not hesitate to ask.
- After hours….should we head to urgent care/ER?
The other question that can be incredibly confusing, especially on a Sunday afternoon or overnight when the office is closed, is “Should we go to the Emergency Department?” We would never tell a parent not to use their intuition since you know your child best, but sometimes it is hard to be objective when the situation is emotionally charged with worry and concern for your child. Unless your child is in respiratory distress or you feel like you need to call an ambulance, you should always call us first.
Nine times out of ten, we can help you avoid the ED. We can talk through the scenario and provide you with real-time instruction on whether we need to see your child at the office or follow up via phone call a few times if we are watching an illness evolve when the office is closed. We are available 24 hours a day, regardless of whether the physical office is open or closed. If we think that you need a higher level of care at the ED, we will absolutely tell you that too. Oftentimes, one can pick up new germs in the waiting room of the ED and inside the ED. Sometimes the safest thing you can do is call us and let us help you decide if going to the ED is the right choice.
The same scenario is true for an Urgent Care. Call us first! Most likely we can resolve the issue with a televisit, or just verbal directions and a check the next day. Urgent care docs usually are not trained in pediatrics, so your child may receive intervention that they don’t need (tests and/or antibiotics). Let us help direct you.