Tele-triage for Blood in Urine (Hematuria) in Children

Audience: pediatric

Blood in a child's urine, known as hematuria, can be concerning for parents and caregivers. It may appear as pink, red, or brown urine and can result from various causes, some minor and others more serious. Telemedicine can help assess symptoms, gather medical history, and guide families on next steps. However, some situations require urgent in-person evaluation. This guide helps caregivers understand when tele-triage is appropriate for a child with blood in their urine and when to seek immediate medical attention. Early recognition of warning signs and proper follow-up can support better health outcomes for children.

Red flags — go in person / ER

• Child has difficulty breathing, severe pain, or is confused — seek emergency care immediately.
• Child shows heavy bleeding with blood clots in urine or inability to urinate — go to emergency department.
• Child has fever with chills, swelling of face or limbs, or decreased urination — urgent medical evaluation needed.

What telemedicine can do

• Initial symptom assessment and history taking for blood in urine.
• Guidance on when to seek in-person care or emergency services.
• Advice on sample collection and follow-up testing.
• Monitoring mild symptoms and providing reassurance.

What telemedicine cannot do

• Performing physical examination or procedures requiring hands-on care.
• Diagnosing underlying causes without lab or imaging tests.
• Managing severe symptoms or emergencies.
• Administering treatments or interventions that require in-person visits.

What is Hematuria in Children?

Hematuria means there is blood in the urine. In children, it may be visible (called gross hematuria) or found only on lab tests (microscopic hematuria). Causes can include urinary tract infections, minor injuries, kidney problems, or other conditions. Not all causes are serious, but any blood in urine should be evaluated by a healthcare provider.

When to Use Telemedicine for Hematuria

Telemedicine can help by reviewing your child's symptoms, medical history, and any other signs. It is useful for initial assessment, especially if your child feels well and has no other concerning symptoms. The healthcare provider can advise if further tests or in-person visits are needed.

Signs That Need Immediate In-Person Care

If your child has any of the following, seek emergency care right away:

These signs may indicate serious illness requiring urgent evaluation.

What to Expect During a Telemedicine Visit

During the tele-visit, the provider will ask about:

They may recommend urine tests or imaging if needed, and guide you on next steps.

Follow-Up and Monitoring

After the tele-visit, follow the provider's advice carefully. This may include:

Keep track of any changes and report them promptly.

How to prepare for your tele-visit

• Have a list of your child's symptoms and when they started.
• Note any recent injuries, illnesses, or medications.
• Prepare information about your child's medical and family history.
• Have a sample of your child's urine if possible for visual inspection.
• Be ready to describe any other symptoms like fever, pain, or swelling.

After your tele-visit

• Follow provider instructions for urine tests or imaging if ordered.
• Monitor your child’s symptoms closely and note any changes.
• Seek in-person care if red flag symptoms develop.
• Keep scheduled follow-up appointments or tele-visits.
• Maintain hydration and comfort measures as advised.

FAQs

What causes blood in my child's urine?

Blood in urine can come from infections, minor injuries, kidney problems, or sometimes from vigorous exercise. Sometimes it may be due to more serious conditions, so evaluation is important.

Is blood in urine always visible?

Not always. Sometimes blood is only seen under a microscope during urine tests, called microscopic hematuria. Visible blood is called gross hematuria.

Can telemedicine diagnose the cause of blood in urine?

Telemedicine can help assess symptoms and guide next steps, but diagnosis often requires physical exams, urine tests, or imaging that need in-person visits.

When should I take my child to the emergency room?

If your child has severe pain, trouble breathing, heavy bleeding, blood clots in urine, fever with chills, swelling, or decreased urination, seek emergency care immediately.

How can I prepare for a telemedicine visit about my child's hematuria?

Prepare a list of symptoms, any recent injuries or illnesses, your child's medical history, and have a urine sample ready if possible. This helps the provider assess your child's condition better.

Sources

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

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