Red flags & when to go in person for Blood in Urine (Hematuria) - Triage

Audience: pediatric

Blood in a child's urine, known as hematuria, can be worrying. It may appear as pink, red, or brown urine. Sometimes, it happens due to minor causes like a urinary tract infection or injury. However, blood in urine can also signal more serious conditions. Telemedicine can help evaluate symptoms, provide guidance, and suggest if further tests or treatments are needed. It's important to watch for specific warning signs that require in-person medical care. Early recognition of these signs helps ensure your child receives timely and appropriate treatment. This guide explains when telemedicine is suitable and when to seek urgent, face-to-face medical attention for blood in urine in children.

Red flags — go in person / ER

• Large amounts of visible blood or blood clots in urine — seek urgent in-person evaluation.
• Fever, severe pain, or difficulty urinating alongside blood in urine — go to a healthcare facility promptly.
• Swelling in face, hands, or feet or signs of anemia (paleness, fatigue) — require urgent medical care.

What telemedicine can do

• Initial assessment of mild blood in urine without severe symptoms.
• Review of medical history and symptom discussion.
• Guidance on home care and monitoring.
• Follow-up visits after initial evaluation.

What telemedicine cannot do

• Severe symptoms such as heavy bleeding or inability to urinate.
• Signs of infection with fever and pain needing physical examination.
• Swelling or signs of anemia requiring urgent testing.
• Emergency situations needing immediate interventions.

What is Blood in Urine (Hematuria)?

Hematuria means there is blood in the urine. In children, it may look like pink, red, or brown urine. Sometimes the blood is only seen under a microscope and not visible to the eye. Causes can range from mild issues like infections or minor injuries to more serious kidney or bladder problems.

When Can Telemedicine Help?

Telemedicine can be useful to discuss your child's symptoms, review medical history, and decide if tests or treatments are needed. A healthcare provider can guide you on home care and when to watch closely. Telemedicine is often suitable for initial assessments and follow-ups when symptoms are mild and your child is stable.

Red Flags That Need In-Person Care

Certain signs mean your child should be seen in person quickly:

If any of these occur, seek urgent medical evaluation.

Preparing for a Telemedicine Visit

Before your tele-visit, gather information such as:

This helps the provider make the best assessment.

After the Telemedicine Visit

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

Stay in touch with your provider if symptoms change.

How to prepare for your tele-visit

• Note the time and appearance when blood in urine was first noticed.
• List any other symptoms like pain, fever, or swelling.
• Gather your child's medical history and any medications.
• If possible, collect a fresh urine sample in a clean container.
• Ensure a quiet, private space with good internet connection for the tele-visit.
• Prepare questions or concerns to discuss with the provider.

After your tele-visit

• Follow all instructions given by the healthcare provider.
• Monitor your child's urine and symptoms closely.
• Complete any recommended urine tests or lab work.
• Schedule an in-person visit if symptoms worsen or red flags appear.
• Keep emergency contact numbers handy in case urgent care is needed.
• Report any new or worsening symptoms promptly to your provider.

FAQs

What causes blood in my child's urine?

Blood in urine can be caused by infections, injuries, kidney or bladder problems, or sometimes from vigorous exercise. Many causes are mild, but some need medical attention.

Can telemedicine diagnose the cause of blood in urine?

Telemedicine can help assess symptoms and decide if tests or in-person care are needed. However, some causes require physical exams and lab tests that must be done in person.

When should I take my child to the emergency room?

If your child has heavy bleeding, blood clots, severe pain, fever, swelling, or cannot urinate, seek emergency care immediately.

Is blood in urine always visible?

Not always. Sometimes blood is only seen under a microscope during urine tests. Visible blood is easier to notice but not the only sign of hematuria.

Can blood in urine go away on its own?

Sometimes, mild causes resolve without treatment. But it's important to have a healthcare provider evaluate your child to rule out serious conditions.

Sources

1. Hematuria in Children — MedlinePlus, U.S. National Library of Medicine.
2. Hematuria: Causes and Diagnosis — Mayo Clinic.
3. Urinary Tract Infection in Children — Centers for Disease Control and Prevention (CDC).
4. Evaluation of Hematuria in Children — American Academy of Pediatrics (AAP).

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person evaluation, diagnosis, or treatment by a qualified healthcare professional. If your child has severe symptoms or you are concerned, seek immediate medical care.