Fever & Emergencies

Signs Your Child Needs the Emergency Room — Not Just the Clinic

Filipino parents often face a critical decision: rush to the ER or wait for the clinic to open? This guide gives you a clear, definitive list of signs that require immediate emergency care — and signs that can safely wait for a clinic visit.

Updated April 2026 6 min read PPS Guidelines

Go to the ER Immediately

These signs require emergency evaluation. Do not wait for the clinic to open. Go to the nearest hospital ER now.

Breathing Problems

  • Breathing faster than normal for age (over 60/min in newborns, over 50/min in infants, over 40/min in toddlers)
  • Chest indrawing — skin pulling in between ribs with each breath
  • Flaring nostrils with each breath
  • Blue or purple lips, tongue, or fingernails (cyanosis)
  • Grunting sound with each breath
  • Stridor — high-pitched noise when breathing in

Fever Red Flags

  • Any fever (38°C or higher) in a baby under 3 months
  • Fever above 40°C in any child that does not respond to paracetamol
  • Fever lasting more than 5 days
  • Fever with stiff neck and severe headache
  • Fever with non-blanching rash (rash that does not fade when pressed)

Neurological Signs

  • Seizure (kejang) lasting more than 5 minutes
  • Multiple seizures in 24 hours
  • Child cannot be woken up or is unresponsive
  • Extreme lethargy — much more sleepy than usual
  • Bulging fontanelle (soft spot on head) in infants
  • Sudden severe headache — 'worst headache of my life'

Dehydration Signs

  • No urination for 8+ hours (no wet diapers in infants)
  • Sunken eyes
  • Dry mouth and no tears when crying
  • Sunken fontanelle (soft spot) in infants
  • Skin that stays pinched when pulled (poor skin turgor)
  • Extreme thirst or refusal to drink

Dengue Warning Signs

  • Severe abdominal pain or tenderness
  • Persistent vomiting (3+ times in 24 hours)
  • Bleeding from gums, nose, or in urine/stool
  • Rapid breathing with cold, clammy skin
  • Restlessness or extreme lethargy
  • Fever that suddenly drops after 3–5 days (danger period begins)

Injury and Trauma

  • Head injury with loss of consciousness, even briefly
  • Head injury with vomiting more than once
  • Suspected broken bone
  • Deep cut that won't stop bleeding after 10 minutes of pressure
  • Burns larger than the child's palm
  • Suspected poisoning or ingestion of medicine/chemicals

See a Doctor at the Clinic (Not ER)

These signs need medical evaluation but are not emergencies. See your pediatrician at the clinic within 24 hours.

  • Fever lasting more than 3 days in a child over 2 years
  • Ear pain or pulling at ear with fever
  • Sore throat with difficulty swallowing
  • Persistent cough for more than 2 weeks
  • Rash without fever that is spreading
  • Diarrhea lasting more than 3 days without dehydration
  • Vomiting that has stopped but child is not eating
  • Eye discharge or pink eye
  • Limping or refusing to walk without obvious injury

Safe to Manage at Home

These conditions can be safely managed at home with appropriate care. Monitor closely and see a doctor if symptoms worsen.

  • Mild fever (below 38.5°C) in a child over 6 months who is alert and drinking
  • Common cold with runny nose and mild cough
  • Mild diarrhea (less than 6 times per day) with no dehydration signs
  • Mild vomiting (1–2 times) with no other symptoms
  • Minor cuts and scrapes that stop bleeding with pressure
  • Heat rash (bungang araw) without fever
  • Mild teething discomfort

Philippine Emergency Hotlines

911

National Emergency Hotline

Ambulance, police, fire

1555

DOH Hotline

Health information and referrals

(02) 8527-8385

Philippine Red Cross

Ambulance and blood services

(02) 8588-8000

PCMC (Quezon City)

Philippine Children's Medical Center

(02) 8554-8400

PGH (Manila)

Philippine General Hospital

(02) 8524-1078

Poison Control Center

Poisoning and overdose emergencies

Medical Disclaimer: This content is for informational purposes only. Always consult a licensed Filipino pediatrician for your child's specific health concerns. In a medical emergency, call 911 or go to the nearest hospital immediately.

🆘 Emergency Child Health Advisor

MAIA AI · Available 24/7 · Not a substitute for emergency care

LIFE-THREATENING EMERGENCY? Call 911 or go to the nearest hospital immediately. Do not wait for AI guidance.

What's happening right now?

MAIA
Hi! I'm MAIA, your 24/7 Emergency Child Health Advisor. 💙 I'm here to help you right now. Tell me what's happening with your child — age, symptoms, how long — and I'll guide you step by step. ⚠️ AI guidance only — not a substitute for emergency care. If breathing is affected or your child is unconscious, call 911 immediately.

MAIA AI · For emergencies call 911 · KidSafe PH