ER or Pediatrician’s Office?

When is your child's ailment worth a trip to the emergency room and when is a visit to his or her pediatrician the remedy? Here, a pediatrician with Shelby Pediatric Associates and Child Lung Center offers insight.

The infant with a fever of 101 degrees. The kid who returns from soccer practice with a swollen ankle. The teen complaining of severe stomach cramps. At every stage in your child’s life, you will have at least one moment when you ask yourself, “Should we go to the emergency room?”

It can be easy to panic and rush to the ER when your child is ill or injured, but many times issues can be solved with a call to your kid’s doctor.

Stop for a minute and assess the situation, says Dr. Salvatore Ventimiglia, a pediatrician at Shelby Pediatric Associates and Child Lung Center, with locations in Shelby Township and Troy.

Here, Dr. Ventimiglia offers insight for parents on when to take kids to the ER and when a call to your child’s doc should suffice.

ER bound

Fever is the most common reason for parents to take their child to the ER.
“Whether it’s the degree of fever – how high it is – or it’s just their first time having a fever,” he says, “many times the parents will choose to go to the emergency room or urgent care to have it evaluated.”

While any child under the age of 2 to 3 months with a fever should be seen right away, oftentimes Dr. Ventimiglia says he prefers to look at the whole picture.

“Higher fevers above 103 can signal a more serious infection, but I think what worries me the most is the whole picture,” he says. “A high fever in a child that is difficult to console, that is not feeding well or eating well or maybe has vomited and there are worries for dehydration – that whole picture worries me more than the relatively happy, consolable child with a 102 fever.”

If your child seems dehydrated in the middle of the night, he or she could require immediate attention in the ER, however Dr. Ventimiglia does suggest calling your child’s doctor for advice and guidance first.

When it comes to infants, the signs that an ER trip is required are more subtle, he says, “but probably the most significant would be poor feeding, refusing feedings, an inconsolable, listless and crying child.”

If your child sustained an injury during sports or dance practice or you suspect they’ve broken a bone, head to the ER right away.

“Any serious injury is probably best handled there so testing and things can be done efficiently,” he says.

If you do end up at the ER, don’t be afraid to ask questions, Dr. Ventimiglia advises, and be sure to communicate.

“There’s a lot of people that will be in and out of your room in an emergency room,” he says. “Make sure that you’ve let everyone know on the team what is going on, and also if your child has a chronic illness, letting them know right up front,” he adds.

Bring a list of medicines your child is on, and do not assume that the information is in the computer – even if it is a place you’re been to several times. There could be wrong dosage information or missing medicines on that list.

Call the doc

Heading to the ER in a panic may seem like the best thing to do in the moment, but the reality is that many ERs are not equipped to treat children, he says. Pediatric hospitals in the area would be the best place to take your child, if needed.

“The potential of exposure to something worse is more likely at the emergency room, and also the emergency room isn’t really a first-come, first-served basis.”

You could spend hours to be reassured that this isn’t anything very serious, so many parents end up losing time and money in the end.

Instead, if you’re worried your child needs medical attention, reach out to his or her pediatrician.

“Even during the day, we have a triage desk that helps just answer questions for parents so we can say, ‘Why don’t you just try this first?'” he adds.

If a child has cold-like symptoms, cough, congestion and stuffiness, there is no need to take him or her to the ER. Instead, call the pediatrician for guidance, and if necessary, you might be directed to make an appointment.

For more information on Shelby Pediatric Associates and Child Lung Center, visit


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