Red flags & when to go in person for Pneumonia (Suspected) - Triage

Audience: pediatric

Pneumonia is an infection that affects the lungs and can make it hard for children to breathe. It often causes cough, fever, and chest pain. While many cases can be managed at home, some signs mean your child needs urgent medical care. This guide helps parents and caregivers understand when to seek in-person care for suspected pneumonia in children. Telemedicine can provide advice and help decide if a visit to a healthcare facility is needed. Watch closely for danger signs such as difficulty breathing, persistent high fever, or changes in alertness. Early recognition and care can prevent complications. Remember, telemedicine is useful for guidance but cannot replace hands-on medical evaluation when serious symptoms appear.

Red flags — go in person / ER

• Difficulty breathing such as fast breathing, grunting, or chest retractions — seek emergency care immediately.
• Blue or gray color around lips, face, or fingernails — call emergency services right away.
• Child is very sleepy, difficult to wake, confused, or has seizures — urgent in-person evaluation needed.

What telemedicine can do

• Initial symptom assessment and history taking.
• Providing guidance on home care for mild symptoms.
• Helping decide if in-person evaluation is needed.
• Answering questions about pneumonia and its signs.

What telemedicine cannot do

• Performing physical examination such as lung auscultation.
• Ordering or interpreting diagnostic tests like chest X-rays or blood tests.
• Managing severe or emergency symptoms.
• Prescribing medications without in-person evaluation when red flags are present.

What is Pneumonia in Children?

Pneumonia is an infection that inflames the air sacs in the lungs. In children, it often starts with a cough and fever. The lungs may fill with fluid or pus, making it harder for your child to breathe. Pneumonia can be caused by viruses, bacteria, or other germs. Young children and those with other health problems are more at risk.

Common Symptoms to Watch For

Children with pneumonia often have:

Symptoms can vary by age and severity. Some children may also have vomiting or belly pain.

When to Seek In-Person Medical Care

Certain signs mean your child needs urgent evaluation by a healthcare professional in person. These include:

If you see any of these, seek emergency care immediately.

How Telemedicine Can Help

Telemedicine can be a helpful first step. A healthcare provider can:

However, telemedicine cannot perform physical exams, listen to the lungs, or order tests. It is not suitable for emergencies.

Preparing for a Telemedicine Visit

Before your tele-visit, prepare to:

After the Telemedicine Visit

Follow the healthcare provider’s advice carefully. This may include:

Keep emergency numbers handy and do not delay care if your child’s condition changes.

How to prepare for your tele-visit

• Have a list of your child’s symptoms and when they started.
• Know your child’s medical history and any current medications.
• Measure and note your child’s temperature and breathing rate if possible.
• Be in a quiet place with good internet or phone signal.
• Prepare to describe your child’s breathing, behavior, and any changes clearly.

After your tele-visit

• Follow the healthcare provider’s instructions carefully.
• Monitor your child’s breathing, temperature, and overall condition.
• Give medications as directed and keep your child comfortable.
• Seek in-person care if symptoms worsen or red flags appear.
• Keep emergency contact numbers easily accessible.

FAQs

Can pneumonia be treated at home?

Many mild cases of pneumonia in children can be managed at home with rest, fluids, and medications as advised by a healthcare provider. However, close monitoring is important to detect any worsening symptoms.

How can I tell if my child’s breathing is too fast?

You can count your child’s breaths by watching their chest rise and fall for one full minute. Fast breathing rates vary by age, but generally, more than 60 breaths per minute in infants under 2 months, more than 50 in infants 2–12 months, or more than 40 in older children may be concerning.

Is a cough always a sign of pneumonia?

Not always. Cough can be caused by many illnesses, including common colds or bronchitis. Pneumonia usually comes with other signs like fever and difficulty breathing.

When should I go to the emergency room for my child’s cough?

Go to the emergency room if your child has trouble breathing, blue lips or face, is very sleepy or unresponsive, has a high fever that won’t come down, or has seizures. These are serious signs that need immediate care.

Can telemedicine replace an in-person visit for pneumonia?

Telemedicine is useful for initial advice and deciding if your child needs to be seen in person. It cannot replace physical exams or urgent care when serious symptoms are present.

Sources

1. Pneumonia in Children — MedlinePlus, U.S. National Library of Medicine.
2. Pneumonia - Symptoms and Causes — Mayo Clinic.
3. Pneumonia in Children: Clinical Features and Diagnosis — National Library of Medicine.
4. Pneumonia: When to Seek Emergency Care — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care. If your child shows any signs of severe illness or red flags, seek emergency medical attention immediately.