Red flags & when to go in person for Panic Attacks - Triage

Audience: pediatric

Panic attacks can be very scary for children and teens. They often cause sudden feelings of intense fear or discomfort, along with physical symptoms like a fast heartbeat or trouble breathing. While many panic attacks can be managed safely at home or through telemedicine, some signs mean a child should see a healthcare provider in person right away. These include chest pain, fainting, or symptoms that might be caused by other serious health problems. This guide helps families understand when to seek urgent care and what to expect from telemedicine visits. It also explains how telemedicine can support managing panic attacks and when in-person evaluation is necessary. Remember, this information is for education only and not a substitute for professional medical advice or diagnosis.

Red flags — go in person / ER

• Chest pain or pressure lasting more than a few minutes — seek emergency care immediately.
• Fainting or loss of consciousness — go to the nearest emergency room.
• Severe difficulty breathing, blue lips or face, or inability to speak — call emergency services right away.

What telemedicine can do

• Discussing symptoms and history of panic attacks.
• Providing education on coping strategies and relaxation techniques.
• Determining if symptoms require urgent in-person evaluation.
• Supporting follow-up care and medication management if prescribed by a provider.

What telemedicine cannot do

• Performing physical exams or vital sign measurements.
• Diagnosing other medical conditions that mimic panic attacks.
• Providing emergency care for severe symptoms.
• Administering tests like ECG or blood work.

What is a Panic Attack?

A panic attack is a sudden episode of intense fear or discomfort that reaches a peak within minutes. It can cause symptoms like a racing heart, sweating, shaking, shortness of breath, or feeling dizzy. Panic attacks are common in children and teens and can be very frightening, but they are not usually dangerous on their own.

Common Signs and Symptoms

During a panic attack, a child may experience:

These symptoms often peak within 10 minutes and then gradually improve.

When to Seek In-Person Care

Some symptoms need urgent evaluation by a healthcare provider in person. Go to an emergency room or urgent care if your child has:

If you are unsure, it is safer to get in-person care promptly.

How Telemedicine Can Help

Telemedicine can be a good way to talk to a healthcare provider about panic attacks. Providers can:

However, telemedicine cannot perform physical exams or tests needed to rule out other causes of symptoms.

Preparing for a Telemedicine Visit

Before your tele-visit, try to:

This helps the provider give the best care possible remotely.

How to prepare for your tele-visit

• Choose a quiet, private place for the telemedicine visit.
• Have a list of your child's symptoms and when they started.
• Prepare to describe any recent stressful events or triggers.
• Gather information on any medications or supplements your child is taking.
• Have a phone or paper ready to take notes during the visit.

After your tele-visit

• Follow the healthcare provider's advice on managing panic attacks.
• Practice recommended breathing and relaxation exercises regularly.
• Schedule follow-up appointments if suggested.
• Seek in-person care if new or worsening symptoms occur.
• Keep a symptom diary to share with your provider at future visits.

FAQs

What causes panic attacks in children?

Panic attacks can be triggered by stress, anxiety disorders, or sometimes without a clear cause. They often happen during times of change or emotional upset. Genetics and brain chemistry may also play a role.

Can panic attacks be dangerous?

Panic attacks themselves are not usually dangerous, but their symptoms can feel very frightening. It is important to rule out other health problems that may cause similar symptoms. If your child has severe symptoms like chest pain or fainting, seek emergency care.

How can I help my child during a panic attack?

Stay calm and reassure your child they are safe. Encourage slow, deep breaths and help them focus on something grounding, like naming objects in the room. Avoid telling them to 'just calm down,' as this may increase their distress.

When should I take my child to the hospital?

Go to the hospital if your child has chest pain, fainting, severe trouble breathing, confusion, or any signs of a serious illness. If unsure, it is better to seek care promptly.

Can telemedicine replace in-person visits for panic attacks?

Telemedicine is helpful for education, counseling, and follow-up but cannot replace physical exams or emergency care. Some situations require in-person evaluation to ensure safety and proper diagnosis.

Sources

1. Panic Attacks and Panic Disorder — MedlinePlus | U.S. National Library of Medicine.
2. Panic Disorder — Mayo Clinic.
3. Panic Disorder: Symptoms and Causes — National Institute of Mental Health (NIMH).
4. Panic Attacks and Panic Disorder in Children and Adolescents — American Academy of Child & Adolescent Psychiatry (AACAP).

This telemedicine guidance is for educational purposes only and is not a substitute for professional medical care. If your child has severe or worsening symptoms, seek in-person medical evaluation promptly.