Red flags & when to go in person for Nausea and Vomiting in Children

Audience: pediatric

Nausea and vomiting are common symptoms in children and often result from mild causes like stomach viruses or motion sickness. While many cases improve with simple home care, some signs suggest a more serious problem that needs in-person medical attention. This guide helps parents and caregivers understand when to seek urgent care for a child with nausea and vomiting. It explains warning signs such as persistent vomiting, signs of dehydration, severe abdominal pain, or changes in consciousness. Telemedicine can be helpful for initial evaluation, advice on symptom management, and deciding if your child needs to be seen in person. However, certain symptoms require immediate physical examination and possibly tests that cannot be done remotely. Knowing these red flags can help keep your child safe and ensure timely care when needed.

Red flags — go in person / ER

• Vomiting that lasts more than 24 hours or occurs more than 5 times in 6 hours — seek in-person care.
• Signs of dehydration such as dry mouth, no tears when crying, sunken eyes, or very little urine — go to a healthcare facility.
• Severe abdominal pain, high fever, confusion, lethargy, or seizures — seek emergency medical attention immediately.

What telemedicine can do

• Initial symptom assessment and advice for mild nausea and vomiting.
• Guidance on hydration and home care strategies.
• Determining if symptoms require urgent in-person evaluation.

What telemedicine cannot do

• Physical examination to diagnose serious causes like appendicitis.
• Administration of intravenous fluids or medications.
• Emergency treatment for severe dehydration, altered consciousness, or seizures.

Common Causes of Nausea and Vomiting in Children

Children often experience nausea and vomiting due to mild infections like stomach viruses, food reactions, or motion sickness. These usually get better with rest and fluids. Sometimes, more serious causes like appendicitis, dehydration, or poisoning may be involved, so careful observation is important.

When to Seek In-Person Medical Care

If your child shows any of the red flags listed below, it is important to go to a healthcare facility promptly. Persistent vomiting lasting more than 24 hours, inability to keep any fluids down, severe belly pain, high fever, or signs of dehydration require immediate evaluation. Also, if your child is very sleepy, confused, or has seizures, urgent care is needed.

How Telemedicine Can Help

Telemedicine allows you to speak with a healthcare provider quickly to discuss your child’s symptoms. Providers can offer advice on managing mild symptoms, hydration tips, and when to seek in-person care. They can help decide if your child’s condition needs urgent attention or can be safely managed at home.

Limitations of Telemedicine for Nausea and Vomiting

Some conditions require physical exams, blood tests, imaging, or treatments that cannot be done remotely. Telemedicine cannot replace emergency care if your child is seriously ill. Always seek in-person care if your child has severe symptoms or worsening condition.

Preventing Complications at Home

Offer small sips of clear fluids often to prevent dehydration. Avoid solid foods until vomiting stops. Watch your child closely for any worsening symptoms or new signs of illness. Keep a record of how often vomiting occurs and any other symptoms to share with your healthcare provider.

How to prepare for your tele-visit

• Note the duration and frequency of vomiting episodes.
• Observe and record any other symptoms such as fever, pain, or behavior changes.
• Have a list of your child's current medications and allergies ready.
• Prepare to describe your child's fluid intake and urine output.
• Ensure a quiet, well-lit space with a stable internet connection for the tele-visit.

After your tele-visit

• Follow the healthcare provider’s advice on fluid intake and diet.
• Monitor your child closely for any new or worsening symptoms.
• Keep track of vomiting episodes and any other symptoms to report in follow-up.
• Seek in-person care if red flags develop or symptoms do not improve as advised.
• Schedule a follow-up telemedicine or in-person visit if recommended.

FAQs

Can I give my child medicine to stop vomiting?

Over-the-counter anti-nausea medicines are not usually recommended for young children without a doctor's advice. Some medicines may have side effects or mask important symptoms. Always ask a healthcare provider before giving any medication.

How can I tell if my child is dehydrated?

Signs of dehydration include dry mouth, no tears when crying, sunken eyes or cheeks, unusual sleepiness or fussiness, and fewer wet diapers or trips to the bathroom than usual. If you notice these signs, seek medical care promptly.

Is it safe to use telemedicine for my child’s vomiting?

Telemedicine can be a safe way to get advice for mild symptoms and to help decide if your child needs to be seen in person. However, it cannot replace emergency care if your child is very sick or has serious symptoms.

When should I take my child to the emergency room?

Go to the emergency room if your child has repeated vomiting with inability to keep fluids down, severe abdominal pain, high fever, signs of dehydration, confusion, seizures, or is very sleepy and difficult to wake.

Sources

1. Nausea and Vomiting in Children — MedlinePlus, U.S. National Library of Medicine.
2. Vomiting in Children — American Academy of Pediatrics (AAP).
3. Dehydration in Children — Centers for Disease Control and Prevention (CDC).
4. Vomiting and Nausea: When to Seek Medical Care — Mayo Clinic.

This telemedicine education is for informational purposes only and is not a substitute for professional in-person medical care. If your child has serious symptoms or you are concerned about their health, please seek immediate medical attention.