Pediatricians and emergency medicine specialists have warned that some symptoms in children can progress rapidly within just a few hours. They noted that respiratory infections, fever, dehydration, and injuries resulting from falls or accidents are among the leading reasons families seek care at emergency departments. However, difficulty breathing, seizures, sudden lethargy, persistent vomiting, reduced urination, uncontrolled bleeding, blue lips, and changes in the level of consciousness are among the most important warning signs requiring urgent medical attention without delay.
Doctors also emphasized that parents’ instincts play an important role. If a child appears noticeably different from their usual self, seeking an early medical assessment is the safest course of action.
Doctors explained that children typically account for between 20% and 30% of total emergency department visits, depending on the type of healthcare facility. Fever and respiratory illnesses are the leading causes of pediatric emergency visits, along with gastrointestinal symptoms such as vomiting, abdominal pain, and diarrhea, as well as seizures and head injuries. Less common, but still encountered, conditions include diabetic ketoacidosis, poisoning, shock, and certain infectious and systemic diseases.
The doctors stressed that prevention begins with family awareness, knowing which warning signs cannot wait, and distinguishing between a temporary symptom and a potentially dangerous sign. They noted that early intervention in pediatric emergencies not only reduces complications but may also be critical in saving a child’s life.
Pediatric Emergencies
Dr. Sabrine Bardouk, Consultant Emergency Medicine, said common pediatric emergencies include respiratory infections, febrile illnesses, dehydration, and injuries, noting that these conditions often require prompt assessment because children can deteriorate more rapidly than adults.
She explained that upper respiratory tract infections account for a significant proportion of pediatric emergency department visits, reaching approximately 50% to 55% in some cases. These are followed by fever, gastroenteritis, asthma or wheezing, ear infections, and injuries such as wounds and fractures.
She said international data indicate that respiratory illnesses and injuries account for the greatest burden of pediatric emergency department visits.
She stressed the importance of seeking immediate medical attention if a child develops breathing difficulties, such as rapid breathing, chest retractions, grunting, or blue lips, as well as any change in the level of consciousness, unusual drowsiness, unresponsiveness, or seizures, particularly if they last for more than three minutes.
Other concerning signs, she said, include persistent vomiting, an inability to keep fluids down, and signs of dehydration such as reduced urination, dry mouth, and absence of tears. Severe injuries, uncontrolled bleeding, or very high fever are also warning signs, particularly in infants or when the temperature exceeds 40.5°C.
She added that distinguishing between mild and serious symptoms depends on monitoring the child’s overall condition rather than focusing on a single symptom. Mild fever in older children, a simple cough, or short-term vomiting and diarrhea when the child remains adequately hydrated may be monitored at home.
However, rapid or labored breathing, refusal to breastfeed or drink fluids, reduced urination for 12 hours or more, lethargy, irritability, inconsolable crying, seizures, or fever accompanied by reduced responsiveness are all signs requiring urgent medical assessment.
She emphasized that dehydration can rapidly progress from mild to severe in children if it is not treated early.
Regarding first aid, Dr. Bardouk encouraged parents to learn basic emergency response skills, particularly for choking, burns, falls, poisoning, and bleeding.
She noted that for choking in infants, five back blows followed by five chest thrusts are recommended, while abdominal thrusts, or the Heimlich maneuver, are used for older children. If the child becomes unresponsive, cardiopulmonary resuscitation (CPR) should be started and emergency services contacted immediately.
For burns, she explained that the affected area should be cooled with running water for at least 20 minutes, while ice, creams, and home remedies should be avoided. The burn should then be loosely covered, with medical attention sought when necessary. In cases of falls or head injuries, parents should monitor the child for vomiting, drowsiness, confusion, or behavioral changes.
In cases of poisoning, she stressed that parents should not attempt to induce vomiting and should seek medical assistance immediately, bringing the substance involved if possible and providing information about the time of ingestion, the amount consumed, and the symptoms.
Warning Signs
Dr. Siddharth Arora, Specialist Paediatrics, said the most common conditions requiring children to be brought to emergency departments include breathing difficulties, seizures, high fever, injuries resulting from accidents, allergic reactions, and accidental ingestion of harmful substances.
He noted that parents should seek urgent medical care if a child develops signs such as difficulty breathing or unusual sounds while breathing, blue lips or face, persistent vomiting, uncontrollable bleeding, sudden lethargy, or seizures lasting more than a few minutes.
He added that monitoring the child’s overall behaviour alongside specific symptoms is essential in distinguishing mild conditions from more serious ones. Some conditions may appear limited in their early stages but can deteriorate rapidly, making close monitoring of symptoms essential and requiring parents not to hesitate to seek medical assistance when in doubt.
Dr. Arora also emphasized the importance of parents having a basic understanding of first aid.
When to Go to the Emergency Department
Dr. Sarah Ali, Consultant Paediatrics, said there are eight warning signs that should prompt parents to take their child to the emergency department immediately. Among the most important is fever in infants younger than two months. Any fever at this age is considered a medical emergency requiring urgent evaluation due to the increased risk of serious infections such as urinary tract infections, bacterial meningitis, and sepsis, as well as the possibility of rapid deterioration.
She added that dehydration is another important warning sign and may present as a dry mouth, sunken eyes, crying with few or no tears, or fewer than three wet diapers within 24 hours.
She explained that confusion, unusual lethargy, excessive sleepiness, difficulty waking the child, or unresponsiveness require immediate medical assessment, whether associated with a head injury, infection, or an acute metabolic condition.
She issued a particular warning about the combination of confusion and lethargy with fever, a skin rash, neck stiffness, and severe headache, as these symptoms may indicate bacterial meningitis, a life-threatening condition that can progress within hours.
She noted that abdominal pain accompanied by bloody stools may indicate a serious condition such as intussusception. A child also requires immediate emergency care if they are struggling to breathe, breathing rapidly, unable to speak in complete sentences, using the muscles between or below the ribs to breathe, experiencing flaring of the nostrils, or becoming pale or blue.
She emphasized that bleeding that does not stop after 10 minutes of direct pressure requires urgent medical attention. The ingestion of toxic substances, medications, or hazardous household items, including button batteries and magnets, should also be treated as a medical emergency.
The Key to Distinguishing Serious Symptoms
Dr. Mamata Bothra, Specialist Paediatrics and Neonatology, said that waiting too long in the hope that symptoms will resolve on their own is one of the most common mistakes parents make. Other mistakes include giving children leftover antibiotics from previous prescriptions, administering incorrect doses of fever-reducing medication, or relying on advice from unverified online sources.
She stressed that focusing solely on reducing a child’s temperature can distract parents from more important indicators, such as the child’s activity level, breathing pattern, hydration status, and responsiveness.
She added that symptoms that may initially appear mild, such as persistent lethargy or poor feeding and reduced food intake, can be early signs of serious illness. In infants, warning signs often manifest through changes in behaviour, including poor feeding, excessive sleepiness, persistent or weak crying, and fewer wet diapers. Older children, meanwhile, are generally better able to describe their symptoms.
She explained that fever is not a disease in itself but is often a sign that the body is fighting an infection. A child may be monitored at home if they remain active, drink fluids well, and respond to fever-reducing medication.
However, immediate medical care is necessary if an infant younger than three months has a temperature of 38°C or higher, if fever persists for more than three days, or if it is accompanied by difficulty breathing, seizures, persistent vomiting, dehydration, severe pain, unusual drowsiness, difficulty waking the child, or a rash that does not fade when pressed or begins to spread.
She emphasized that delaying medical assessment may allow an infection to progress or dehydration and breathing problems to worsen, potentially resulting in complications that could have been prevented through early treatment.
She explained that summer in the UAE is associated with an increase in cases of dehydration, heat exhaustion, heatstroke, sunburn, swimming-related incidents, food poisoning, and foodborne illnesses. Spending long periods indoors in air-conditioned environments may also contribute to the spread of respiratory viruses.
She said air conditioning does not directly cause infections, but prolonged exposure to cold, dry air can dry out the mucous membranes of the nose and throat. In addition, poorly maintained air-conditioning systems may worsen allergy or asthma symptoms due to the accumulation of dust and allergens. She therefore advised regular maintenance of air-conditioning systems and maintaining moderate indoor temperatures.
Dr. Bothra encouraged families to prepare a pediatric first-aid kit containing a digital thermometer, age-appropriate paracetamol or ibuprofen, oral rehydration solution, adhesive bandages, sterile gauze, antiseptic, saline nasal drops, tweezers, small scissors, hand sanitizer, and medical gloves. The kit should also include any emergency medications prescribed for the child when required. Parents should ensure that all medications are within their expiry dates and keep emergency contact numbers readily available.
She stressed the importance of preventing household accidents by never leaving young children unsupervised near water, keeping medications and cleaning products in locked cabinets, keeping hot beverages, electrical cords, and sharp objects out of children’s reach, installing stair gates and window safety measures, using appropriate car seats, and preventing young children from accessing coins, magnets, button batteries, and small objects.
She also emphasized that vaccinations help protect children against serious diseases that may require hospitalization, including meningitis, pneumonia, whooping cough, measles, influenza, and rotavirus infection.
Dehydration and Drowning
Dr. Mahmoud Medhat Abu Moussa, Specialist Critical Care Medicine, highlighted the increase in injuries associated with bicycles and electric scooters, as well as cases involving the ingestion of foreign bodies and household chemicals. He added that travel and summer holiday seasons are associated with an increase in certain infectious diseases, recreational injuries, and swimming-pool incidents.
He explained that emergency departments prioritize cases according to the severity of the condition rather than the time of arrival. Breathing, circulation, level of consciousness, and vital signs are assessed within minutes, with priority given to children facing an immediate threat to life.
He warned of mistakes parents may make while transporting a child to the emergency department, including giving the child food or drink despite the possibility that surgery may be required or that the child may have difficulty swallowing, attempting to physically restrain seizures, or moving a child following a severe head or neck injury.
He emphasized that calling an ambulance is preferable to transporting the child in a private vehicle in cases of respiratory arrest or severe breathing difficulty, loss of consciousness, ongoing seizures, severe bleeding, or serious injuries.
Read more at:
