Wondering if your sick kid needs to go to the emergency room? Here are the signs that they need urgent medical care, straight from an ICU nurse

‘Tis the season. The kids are back in school, which means they’re cozying up in their little Petrie dishes, coughing and sneezing all over each other, and bringing home every illness under the sun. For people who have kids, fall and winter are better known as “those months when at least one family member is sick 100% of the time.” But one of the most stress-inducing things about the onslaught of never-ending illnesses is sussing out what’s regular mom anxiety about having a sick kid and what’s actually a medical emergency. When is it time to pack up a congested, fever-ridden kiddo and seek out help ASAP?

Thankfully, this pediatric nurse is here to help. TikTok user @alittlestitioushere is board-certified in neonatology and pediatrics and works in a children’s ICU. In a now-viral TikTok video, she shares symptoms parents should watch out for.

“Our pediatric ICU has totally exploded about the past three nights, and all of the new admissions are respiratory illnesses leading to respiratory failure,” she explains at the start of her video. “These kids are on 20 to 30 liters per minute of oxygen high flow and some of them are on BiPAP, which is like a ventilator but without the tube in your throat.”


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♬ original sound – ALittleStitiousHere

She explains that the illnesses she sees landing kids in the hospital right now include those that parents are probably very familiar with, like RSV, rhino-enterovirus, and human metapneumovirus (hMPV). She also offers a few tips to help keep kids healthy and stop the spread: Keep kids home when they’re sick, keep unvaccinated newborns home all the time, don’t let anyone kiss your new baby, and wash your hands after going out in public.

Then @alittlestitioushere shares the three signs she says parents should watch out for if they already have a sick kid at home. If you see any of these, she says, it’s time to take your kiddo to the ER ASAP.

First, struggling to breathe.

“Any muscles that are extra that shouldn’t be used for just normal breathing like sucking in between the ribs, breathing hard with the belly, sucking in above the collar bones,” she says. “You know, just anything that just looks like more so than usual. That’s something that you don’t want to wait until the morning. They need to go to urgent care, the ER. Don’t let that get ahead of you.”

The second sign is lethargy. She explains that because kids are so resilient, when these illnesses start to wear them down, it’s usually a pretty bad sign.

“If we felt the way they did, we wouldn’t get out of bed,” she says. “Kids will just go and go and go. So, if your kids starting to get tired out, they need to be seen in the ER.”

And finally, look out for nasal flaring—when your child’s nostrils widen while they breathe. It’s usually a sign they’re struggling to get enough oxygen.

“Just make sure it’s not because they’re so congested in their nose,” she clarifies. “Saline drops in the nose and suction them out real good. If they’re old enough, let them use the neti pot with distilled water, things like that just get all that snot out.”

Having a sick kid can be scary. But knowing the signs to watch for makes it a little less so.

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