As cooler weather sets in, cases of upper respiratory infections (URIs) inevitably rise. During this time, many parents and caregivers face a familiar dilemma: Should I bring my child in for testing, or wait it out at home? Deciding between managing symptoms at home, a visit to your primary care provider, or in certain cases a trip to the emergency room, can be stressful. 

Before rushing out the door, consider these key questions to help guide your next step. 

When to Seek Emergency Care 

You should bring your child to the emergency room immediately if they experience any of the following symptoms as they could indicate a more serious condition that requires urgent medical evaluation: 

• A fever of 104°F (40.0°C) or higher which is unresponsive to Tylenol or Ibuprofen 

• Unresponsiveness or extreme lethargy 

• If child appears to be struggling to breathe 

• Persistent vomiting 

• Inability to drink fluids (Infant: 3-4 hours / Toddler & above: 6-8 hours) 

• No urine output (Infant: 4-6 hours / Toddler & above: 6-12 hours) 

• Severe sore throat or swollen glands that make it difficult to swallow or breathe 
    

When a Primary Care Visit Is Appropriate 

If your child is alert, able to drink fluids, and their symptoms do not match those listed above, it’s reasonable to manage symptoms at home or to schedule an appointment with their primary care provider the following day or soon after. 

In the meantime, keeping your child comfortable is key. Unless otherwise advised by your provider, over-the-counter (OTC) medications can be used safely. Follow the package instructions for proper dosing, and remember: 

• You may give Acetaminophen (Tylenol) and Ibuprofen (Motrin or Advil) together for the first dose every four hours and then alternate every 4 hours as needed for comfort and fever control. 
    

Understanding Testing and Treatment 

If you choose to have your child tested for viral illnesses—whether in primary care or the ER—your provider will review the results and recommend supportive care based on the diagnosis: 

• Positive COVID test: Rest, fluids, and pain or fever management 

• Positive Flu test: Rest, fluids, and pain or fever management (antiviral medication may be considered in some cases) 

• Positive Strep test: Antibiotics in addition to rest, fluids, and pain management 
    

The Bottom Line 

Most respiratory illnesses in children are viral and resolve with rest, hydration, and comfort measures. However, if your child’s symptoms worsen or you notice any signs of distress, trust your instincts and seek care immediately. When in doubt, your pediatrician or primary care provider is the best place to start for guidance and peace of mind.