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When your child is sick…

Common Childhood Illnesses

Colds and Congestion

Symptoms Include: Runny or stuffy nose, nasal discharge that may be clear, green or yellow, sore throat, productive or non-productive cough, low grade fever, body aches and headaches.

Causes: Common colds are caused by a virus, healthy children can average up to 6 colds per year. Proper hand washing is the best prevention of the common cold.

Home Care for Colds: A runny nose is the natural way of cleansing the nasal passages. Blowing the nose as often as needed is the best way to rid the body of the cold virus. For young children, using bulb suction will help clear the nasal passage since blowing may be difficult. Apply petroleum jelly or Aquaphor by Eucerin in nostrils and underneath the nose to help prevent chapping. For a “plugged” nose you can use nasal washes consisting of warm water or over the counter saline nasal spray to help loosen mucus build up. Instill 2 or 3 drops in each nostril; 1 nostril at a time. Repeat nasal wash every 4 hours or whenever the nasal passage becomes uncomfortably clogged. To make your own saline drops: Add 1⁄2 teaspoon of table salt to 1 cup (8 oz.) warm water. Another option to unblock the nose is to use a warm showers steam to loosen the nasal mucus and using a wet cotton swab may assist in the removal of nasal mucus. Running a humidifier in your home can help with congestion, especially if the air in your home is dry (usually occurring in winter months). Pointe Pediatrics Associates does not typically recommend over the counter cold medications, as they only mask symptoms; they do not treat them, and have a tendency to cause hyperactivity and irritability in an already ill child. Although we do not recommend cold medications, an oral decongestant containing pseudophedrine may be used in children over 6 months of age. Please see the pseudophedrine dosage link below for more information. For fevers, muscle aches and headaches, below 102 F you may use either acetaminophen or ibuprofen to treat symptoms, please see dosing list for more information. To treat a sore throat at home, warm fluids such as tea or chicken broth may help sooth discomfort. Over the counter throat lozenges may also be helpful. For coughing, over the counter cough drops may be helpful. Cough medicine with Dextromethorphan (DM formula), a cough suppressant, can also help. See the underlying dosage sheet for more information.

Call the office for an Appointment if your child has a fever lasting over 72hrs. A fever over 105 F. Or any fever in an infant under 12 weeks old. Nasal discharge lasting over 14 days. A cough lasting over 3 weeks. Your child has a history of asthma and is having difficulty breathing. The child complains of ear pain or a severe sore throat.

Croup Cough

Croup Cough Croup is a tight, low-pitched cough that may sound “barkey” like a seal. Voice or cry may also be hoarse (laryngitis). Kids with croup may also have a stridor, a raspy sound heard with inhalation. Croup can last about 5-6 days and usually becomes worse at night. Children are usually contagious for about 5 days and may return to school and other activities once fever is no longer present.

Home Treatment for Croup: Inhale warm mist from a wet washcloth, humidifier, or foggy bathroom (shower steam) for 20 minutes at a time. If this fails, inhale cool air from breathing near an open refrigerator for a few minutes, or from the outdoors in colder months, for 10 minutes time. Give warm fluids to relax the airway. Suggested fluids are warm apple juice or decaffeinated tea. Avoid this home treatment for children under 4 months old. Use over the counter cough medicine with a cough suppressant (Dextromethorphan “DM”formula) in children over 1 year of age, see dosage link for more information. Corn syrup (2 to 5 ml) may also be used as a homemade cough syrup for children over 1 year. Fevers may be treated at home with either acetaminophen or ibuprofen (see dosage link for more information). Avoid tobacco smoke! Active or second hand smoke will make coughing worse.

Call Doctors office if… A stridor is present, and does not respond to 20 minutes of steam treatment as described above. Your child has rapid or distressed breathing (need to rule out respiratory distress). High fever over 105 F; or a child under 12 weeks old with a fever over 100.4 F rectally. Severe chest pain A sudden onset stridor and fever after 2 days of croup.

GO to ER NOW if… The child is under 1 year and struggling to move air, has retractions, or is wheezing when breathing. Your child is having difficulty breathing or swallowing (should be seen immediately or in ER). Child cannot move neck (refuses to touch chin to chest due to severe pain). Child has choked on a small object prior to onset of croup-like-cough or stridor. Bluish lips or face, child has passed out, child is drooling, spitting, or having difficulty swallowing. An allergic reaction may have caused the onset of cough/ or stridor. Either a new food or medication was recently introduced prior to the start of cough.

Dehydration Prevention Protocol

1. Stop all feedings

2. Give nothing by mouth for 1-2 hours after vomiting.

3. After 2 hrs; begin giving 1 teaspoon of clear fluids Pedialyte or Gatorade, 1⁄2 strength diluted with water, every 15min. for the 2nd hour.

4. If the liquid is tolerated, give 2 teaspoons of clear fluids every 15min. for the 3rd hour.

5. Give three teaspoons of clear liquid every 15min. for the 4th hour.

6. If the fluid is well tolerated by the child, give no more than 2oz. of clear liquid each hour for the next 6-8 hours. DO NOT EXCEED 2oz. EACH HOUR!

7. Keep your child on small amounts of clear fluids for the 1st twenty four hours.

8. Follow the “Bland Diet” for the second twenty four hours.

Call our office or the urgent care if…

  • The vomiting does not stop.
  • Your child refuses to drink anything.
  • Your child has not urinated once in 8hrs.
  • Lacks moisture in the inside of his/her mouth.
Fever

Symptoms and Cause: If fever is the ONLY symptom, it often may be treatable at home. A body temperature of over 100.4 degrees F rectally or tympanic (ear) is considered a fever. A temperature 99.5 degrees F orally, or an axillary (armpit) temperature of over 99.0 degrees F, is also considered a fever. The main cause of a fever is the common cold or other viral infections. Fever may be the only symptom for the first 24hrs. and often the cause of the fever cannot be determined during that time frame.

Home care for fevers: If the fever is under 105F in children over 1 year, under 102.5F in recently vaccinated children or under 100.4F in infants, it may be treated at home. Give children acetaminophen or ibuprofen at home to control fevers using the dosing chart link. Avoid aspirin! Provide cold fluids orally in unlimited amounts (unless the child is also vomiting, if so follow the dehydration protocol). Dress children in lightweight clothing and allow them to sleep with one cotton blanket (avoid bundling). Sponging can be used for a fever over 104F that doesn’t come down with acetaminophen or ibuprofen. Use lukewarm water, 85-90F and always give medicine first! Sponge for 20-30 minutes if your child shivers or becomes cold, discontinue sponging or increase water temperature. Most fevers can last 2-3 days. Call your physician if the fever lasts longer than 72 hours, or your child has any of the symptoms listed below.

Your child should be seen today in the office if…

  • The patient is a newborn (under 1mo. old).
  • The child is under 12 weeks and has a rectal fever over 100.4 degrees F.
  • The child has a fever over 105 degrees F.
  • The patient is shaking or trembling for 1 hr. or more.
  • Inconsolable crying.
  • Child will not move an arm or leg normally.
  • Complains of burning or pain with urination.
  • Child shows signs of dehydration (dry mouth, no urination in over 8hrs, lethargic).
  • Patient has a sore throat or ear pain accompanying the fever.

Take your child to the ER now if… 

  • Child is confused.
  • Baby has a bulging soft spot.
  • Stiff neck is present (cannot touch chin to chest due to sever pain).
  • Child has had or is having a seizure from the fever.
  • Respiratory distress is present, child is having difficulty breathing.
  • Chronic diseases such as immonocompromised illness, heart conditions, sickle cell anemia are present.
  • You, the parent are extremely concerned about the child’s well being.
Sore Throat (Pharyngitis)

Symptoms: Pain, discomfort, a “raw” feeling in the back of throat when swallowing. Young children may complain of mouth pain, refuse to eat previously enjoyed foods, or cry during feedings. Most sore throats are a symptom of the common cold, and the sore throat is often the first symptom. About 20% of sore throats are the result of a strep bacteria.

Home Treatment:

  • Remember most sore throats are the result of a viral infection (one that does not require antibiotics); the presence of cough, hoarseness, or nasal congestion point to a virus.
  • Children over 12 months can sip warm chicken broth or apple juice to sooth a sore throat. Children over 4 years may also suck hard candy, children over 6 years may gargle warm salt water or warm water with a small amount of antacid mixed in.
  • Give acetaminophen or ibuprofen for discomfort or if fever is present (see dosing chart for details). Feed children a soft diet, cold beverages and milk shakes are especially helpful.
  • Sore throats accompanying a viral illness can last between 4-5days.

 Call to make an appointment if…

  • Your child has been exposed to strep throat.
  • The sore throat is accompanied by a widespread rash.
  • There is a fever present for over 72hrs.
  • Any fever in children 12 weeks of under.

Go to the ER now if…

  • There is any concern the child may be having difficulty breathing or swallowing.
  • Child has a fever and stiff neck (cannot touch chin to chest due to severe pain).
  • They have an inability to open their mouth completely.
  • Child has a fever over 105F and is 12 months or older.
  • Decreased eating/drinking in children under 2 years (lack of urination for 8 hours or more, very dry mouth and tongue, tears do not exist though crying, child is lethargic).
Vomiting and Gastroenteritis

Vomiting and Diarrhea can be a result of several things; a gastrointestinal- virus is the most common cause. This starts with vomiting usually for 24- 48hrs. and can follow with several days of loose stools. If the vomiting is being caused by something other than a stomach virus your child should be seen ASAP by either their physician or at the nearest emergency room.

Things to monitor and call your doctor or go to ER if present…

  • Dehydration: (grayish skin color, lethargic, no urination w/in 8 hrs time, very dry mouth, no tears if crying).
  • Difficulty awakening
  • Confusion upon awakening
  • Stiff neck, bulging area on neck
  • Child ate or drank something not intended for consumption (cleaning supplies, medication not prescribed for them etc).
  • Child vomits everything for more than 24hrs if under the age of 2 or more than 48hrs if over the age of 2yrs.
  • Child seems like they need medical attention immediately (call 911)
  • The child has blood in vomit or what looks like “coffee grounds” in vomit.
  • The child is under 12 weeks old and has bile in vomit that is yellow or green.
  • Child has a fever of 105 F or in infants (under 12 wks) a rectal temp – of 100.4 or higher.
  • Child has just begun taking a prescription medication and may be having a reaction.

There is no medication that can cure a gastro-virus. Please call our office if your child has any of the above symptoms or you become concerned. Remember to follow the above dehydration prevention protocol and if your child continues to vomit you must begin the re-hydration process from the beginning.

Injuries

Frostbite and Cold Injuries

Mild Frostbite or Frostnip symptoms are: cold, tingling, and painful skin after prolonged exposure to cold.

True Frostbite appears as white, hard, completely numb skin. It can be serious and always requires medical attention after re-warming.

The cause: the nerves, blood vessels, and skin, become temporarily frozen. The wind-chill, and presence of wet clothing determine how quickly it occurs. Commonly found on toes, fingers, the tip of the nose, ears and cheeks.

Degrees of Frostbite are similar to burns:

  • First-degree: white, waxy (hard) skin while frozen, mild erythema and swelling after re-warming.
  • Second-degree: same as first degree plus blisters after 24hrs.
  • Third-degree: hemorrhagic blisters progressing to skin necrosis.

Hypothermia is defined as the bodies temperature under 95 F or 35 C taken rectally and can be fatal without intervention.

Home Care for Mild-Frostbite:
Re-warming the area with wet heat, place the body part or parts in very warm water (usually a bath) is the quickest approach. Water should be VERY warm 104-108F but not hot enough to burn. Immersion in water should continue until pink color returns to the area signaling the return of circulation (usually takes 30min.) Numbness should have resolved after soaking.
If soaking is not possible, wrap child in blankets to keep warm. Offer warm fluids to drink.
For true frostbite ibuprofen can be given to aid with discomfort, see dosage chart for more information.

Prevention of frostbite is especially important in those who have had it before. Dress in layers when going outside. Wear a hat (50% of body heat is lost through the head). Change wet clothes (gloves and socks) immediately.

Remind your children of warning signs: painful skin, tingling and numbness all signal the onset of frostnip and they should remove themselves from the cold as soon as possible if signs occur.

Call EMS or go to the ER if…

  • Unconsciousness of difficulty awaking occurs.
  • Child is showing signs of slurred speech or confusion.
  • Body temperature is under 95F when taken rectally.
  • Shivering persists after 10 minutes of re-warming.
  • Severe pain during re-warming, sensation and color fail to return after 1 hour re-warming.
  • Frostbitten area develops blisters.
  • Area appears infected (either severely red or streaked).
Minor Injury Treatment

Injuries are common in athletes and children. They can be the result of unsafe play, overuse, or an accident. Whatever the cause of the injury use the information below to determine how you care for your child.

Home Treatment for minor injuries, strains and sprains:
Apply a cold pack to injured area for 20 minutes at a time (20 on 20 off) for up to 4 hours following the injury. Follow the RICE protocol Rest Ice Compression Elevation for the first 24 to 48hrs. following the injury. Apply compression with an ace wrap, if numbness, tingling, or a change in skin color occurs the compression need to be loosened. Elevate the injured area above the heart to reduce swelling.Give acetaminophen or ibuprofen every 4-6hrs as needed to reduce pain. Pain and swelling can last up to 7 days, if the condition persists for 10 days or the child is getting worse they should be evaluated and have x-rays take to rule out more serious conditions.

Home Treatment for muscular injuries:
Pulled or strained muscles should immediately be treated with a cold or ice pack following the same icing guidelines as sprains and strains. Light stretching of the area may help to reduce pain and muscle cramping due to injury. Rest the area as much as possible for 48hrs. and return to activity as normal once pain is gone. After the first 12 hours, heat or warm baths may be used to sooth muscle aches and pain.

Home Treatment for minor cuts:
Clean the wound with antibacterial soap and water. If bleeding persists apply pressure and elevate the area above the heart. Keep wound covered until and protective scab has formed.
Use of an antibacterial ointment such as Neosporin may help prevent infection.

Call the office or visit the nearest ER if:

  • The child is in severe pain and may have broken a bone.
  • Bone is sticking through the skin.
  • There may be multiple broken bones.
  • Any injury occurs concerning the head and or spine.
  • Skin below the injury looks pale or blue.
  • Joint appears to be dislocated (usually occurring in upper extremities).
  • Cannot walk or bear weight on a limb, or cannot use arm normally.
  • Joint cannot be straighten or bent to allow full range of motion.
  • Bleeding that cannot be stopped with pressure and elevation.
  • A cut looks like it may need stitches.
  • Child has not had a tetanus shot within 5 years for deep or dirty cuts or 10 years for clean cuts.
  • Random unexplained swelling occurs at or near injury site: such as swollen calf, thigh, or joint after day 2 of injury.
  • Child has a history of previous and serious injury to the same area.
  • There is an open wound that appears to be infected (swollen, red, or streaked).