Red flags & when to go in person for COVID-19 in children

Audience: pediatric

COVID-19 can affect children in different ways, ranging from mild symptoms to more serious illness. While many children recover at home, it is important to recognize warning signs that mean your child needs in-person medical care. Telemedicine can help monitor symptoms and provide advice, but certain red flags require immediate attention. This guide explains when to seek urgent care for your child, what telemedicine can and cannot do, and how to prepare for a virtual visit. Always trust your instincts and seek emergency care if your child has trouble breathing, persistent pain, or confusion. Early recognition of serious symptoms can help keep your child safe and get the right care quickly.

Red flags — go in person / ER

• Difficulty breathing or rapid breathing — seek emergency care immediately.
• Bluish lips, face, or extreme paleness — call emergency services right away.
• Persistent chest pain or pressure, new confusion, or inability to wake up — go to the nearest emergency room.

What telemedicine can do

• Assessing mild COVID-19 symptoms in children.
• Providing guidance on home care and symptom monitoring.
• Answering questions about COVID-19 and when to seek care.
• Deciding if in-person evaluation is needed.

What telemedicine cannot do

• Performing physical exams or vital sign measurements.
• Providing emergency treatment for severe symptoms.
• Administering COVID-19 tests or treatments requiring medical equipment.
• Evaluating children with red flag symptoms needing urgent care.

Common COVID-19 symptoms in children

Children with COVID-19 often have symptoms like fever, cough, sore throat, runny nose, fatigue, and sometimes stomach upset such as nausea or diarrhea. Many children have mild illness and recover without special treatment. Symptoms usually appear 2 to 14 days after exposure to the virus.

When to seek in-person care

Some signs mean your child needs urgent medical attention. These include: difficulty breathing or fast breathing, bluish lips or face, persistent chest pain or pressure, new confusion or difficulty waking up, inability to drink fluids or keep them down, and severe or worsening symptoms. If you notice any of these, go to the nearest emergency room or call emergency services.

How telemedicine can help

Telemedicine allows you to connect with healthcare providers from home. It can help assess mild symptoms, provide guidance on care at home, answer questions, and decide if your child needs to be seen in person. Telemedicine is often a safe and convenient way to get support during illness.

Limitations of telemedicine for COVID-19

Telemedicine cannot perform physical exams, take vital signs, or provide emergency treatment. It is not suitable if your child is very sick or has red flag symptoms. In those cases, in-person evaluation is necessary. Also, some tests or treatments require visiting a healthcare facility.

Preparing for a telemedicine visit

Before your tele-visit, have your child's medical history ready, note symptoms and when they started, prepare a list of questions, ensure a quiet space with good internet, and have a thermometer and pulse oximeter if available. This helps the provider make the best assessment.

After your telemedicine visit

Follow the provider's instructions carefully. Monitor your child's symptoms closely. If symptoms worsen or new red flags appear, seek in-person care immediately. Keep track of any medications given and schedule follow-up visits if recommended.

How to prepare for your tele-visit

• Have your child's symptom history ready, including when symptoms started.
• Prepare a list of questions or concerns to discuss.
• Ensure a quiet, well-lit space with a reliable internet connection.
• Have a thermometer and pulse oximeter available if possible.
• Keep your child's medical records or medication list nearby.

After your tele-visit

• Follow the healthcare provider's instructions carefully.
• Monitor your child's symptoms regularly for any changes.
• Seek in-person care if red flag symptoms develop or worsen.
• Keep track of any medications or treatments given.
• Schedule follow-up appointments if recommended.

FAQs

Can telemedicine diagnose COVID-19 in children?

Telemedicine providers can assess symptoms and advise if testing is needed, but they cannot perform COVID-19 tests themselves. Testing usually requires visiting a healthcare facility or testing center.

What should I do if my child has a fever and cough?

Monitor your child's symptoms closely. Use telemedicine to get advice on managing mild symptoms at home. If your child develops difficulty breathing, persistent pain, or other red flags, seek in-person care immediately.

Is it safe to care for my child with COVID-19 at home?

Many children with mild COVID-19 can recover safely at home with rest, fluids, and symptom management. Follow guidance from healthcare providers and watch for any warning signs that need urgent care.

When should I call emergency services for my child?

Call emergency services if your child has trouble breathing, bluish lips or face, persistent chest pain, new confusion, inability to wake up, or cannot keep fluids down. These are signs of serious illness needing immediate care.

Sources

1. COVID-19 in Children and Teens — Centers for Disease Control and Prevention (CDC).
2. Coronavirus Disease 2019 (COVID-19) - Symptoms — Mayo Clinic.
3. COVID-19 Information for Parents and Caregivers — American Academy of Pediatrics (AAP).
4. Coronavirus Disease (COVID-19) Advice for the Public — World Health Organization (WHO).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child shows any emergency symptoms or you are concerned about their health, seek immediate medical attention.