when do you take a 5 year old to the ER with H1N1?

[lnitti]

Do you follow the CDC guidelines:
* Fast breathing or trouble breathing
* Bluish skin color
* Not drinking enough fluids
* Not waking up or not interacting
* Being so irritable that the child does not want to be held
* Flu-like symptoms improve but then return with fever and worse cough
* Fever with a rash

Or do you follow different criteria?

My dd got sick on Sat and was really bad on Sunday. Monday morning, doctors office did a phone diagnosis of H1N1. but she no longer had a fever. She went to school on Tuesday and Wednesday (24 hour fever free), but continued with a cough that has gotten worse. Tonight (wed. night), she woke up with a fever that returned.

So with a returning fever and nasty cough, do I need to take her to the ER? Note: I'm not asking her doc, because on Monday they wanted me to take her into the ER and we didn't because at that time she had no fever and was no longer lethargic. I think it wasn't truly warranted at that time.

What would you do?

[LauraLoo]

With a returning fever, it could indicate a secondary infection - especially with a persistent cough that never went away and is getting worse. It could have moved into bronchitis or pneumonia.

I would take her to the dr. or the ER at this point.

[AGierald]

I would take the baby to the ER.... if your doctor is comfortable giving a "phone diagnosis" of h1n1, the she'd be better off that the ER.

Otherwise, I'd just keep her comfortable. It depends on how high the fever is. If your mommy spidey sense is telling you to go to the ER, then definitely go.

[The4OfUs]

With a *worse* cough and a *returning* fever, I would take to the doctor, walk in, ot ER because as another poster said, concern for a secondary bacterial infection. From what I've read and heard it's not the flu itself so much to worry about (I mean, it sucks and my kids were both laid out for 5 days when they had it 2 weeks ago, and it was lab confirmed) but the secondary bacterial infections, as those can come on and get really bad awfully quickly - that's what most of the complications and hospitalizations are for, the secondary bacterial infections people develop.

Then again, I'm more accepting of allopathic treatment than many here on MDC. So if you're in the 'treat bacterial infections at home with alternative methods' camp (which I'm not slamming at all, it's all a personal preference), then taking to the ER would be kind of pointless.

Me, personally? Viruses I'm all for letting run their couse...but bacterial infections....let's just say we've dealt with MRSA and some really nasty, hard to beat bacterial infections in our family. So while I'm not gung ho to give antibiotics at the slightest sniffle when they're not really necessary (and potentially add to the problem if antibiotic resistance), I am a proponent of using appropriate, at the lowest effective dosage possible antibiotics to clear up an infection that is not showing improvement in a few days' time. Especially when things get better, but then get WORSE, that *to me* is a sign that home treatment is not doing the trick, and is IMO what professional medical treatment is for.

I'd just be prepared to assert yourself and not let them steamroll you or keep you out of the loop - that's my other strong feeling, is that when you DO seek assistance from the medical community, you advocate and assert yourself so they know you're not just taking their word as gospel and you want information and explanations from them, that you want a partnership and not a dictatorship.

[amcal]

I would very quickly get my child to the ER if they had the flu, got better and then got worse again. Everything I've read about major complications occured when people got better and then worse again which indicates a possible secondary infection. It can go from bad to worse in a matter of hours.

I would be at the ER asap.

Hope she feels better soon!

[mommy2maya]

If they don't have the symptoms that are listed on the cdc, if you go to the er you are going to wait and wait and wait. The ERs are filled with people who are going for primary flu care right now.

I would get an appt at your regular drs office, and if you go see them, then they tell you that it is necessary for you to be in the ER, you can skip the hours of waiting and triage.

My kids have all had this nasty virus- they weren't tested, so don't know if it was truly h1n1 or not, but it is suspected it was. Anyway, of my four kids-
one had a fever for 3-4 days, then felt better, and still has the cough two weeks later. The cough didn't come til the fever was gone
two had fever and little bit of tiredness for two days, then seemed better, then the fever returned for a day or two, then the cough came. he also has the cough still, two weeks later
three had the fever for 6days straight, did nothing more than sleep and drink. She has a little cough, but not as bad sounding as teh older kids. it is a week since her fever broke and she is still more tired than usual. We brought her to the dr on the fifth day of constant fever. The dr didn't test her for flu, but said it was likely that is what they had.
four, well, she was barely sick for a weekend, more crabby than anything. her fever only lasted a day or so. No real cough.

[BellinghamCrunchie]

Yes, with a returning fever, I'd take her in. That is exactly what our Ped told us over the phone - if DD gets better then gets worse, bring her in.

[Peony]

I wouldn't go to the ER but a walk-in clinic, but that is just me. Just throwing this out but I know many of the children are in our area that have relapsed, did too much too soon. The docs here are telling parents not to send them back to school right way but wait. DD1 fell ill on Saturday, we kept her home an entire week, but her school changed the H1N1 policy because of all the relapsing kids. They aren't allowed back until a full 72 hours after a fever. DD1 was tired for 2 weeks after the H1N1 so it was a slower recovery.

I hope she is doing better now.