Red flags & when to go in person for Cough

Audience: pediatric

Cough is a common symptom in children and can be caused by many mild illnesses, such as colds or allergies. Telemedicine often helps parents understand when a cough can be safely managed at home and when to seek further care. However, some signs indicate a more serious problem requiring in-person evaluation. These include difficulty breathing, persistent high fever, or coughing up blood. Telemedicine providers can guide families on symptom management, medication use, and when to monitor closely. It is important to watch for warning signs and act promptly to ensure your child's safety. This guide helps parents know what to expect from telemedicine and when to visit a healthcare provider in person for a child's cough.

Red flags — go in person / ER

• Difficulty breathing or rapid breathing — go to emergency care immediately.
• Persistent high fever lasting more than 3 days — seek in-person evaluation.
• Coughing up blood or thick green/yellow mucus — see a healthcare provider promptly.

What telemedicine can do

• Initial assessment of mild to moderate cough symptoms.
• Advice on symptom management and home care.
• Guidance on medication use and follow-up timing.
• Monitoring symptom progression via video or phone.

What telemedicine cannot do

• Severe respiratory distress or difficulty breathing.
• Signs of dehydration or altered consciousness.
• Need for physical examination, imaging, or laboratory tests.
• Emergency situations requiring immediate in-person care.

Common Causes of Cough in Children

Coughs in children often result from viral infections like the common cold or flu. Allergies, asthma, or exposure to irritants can also cause coughing. Most coughs improve with rest and simple care at home. However, some coughs may signal more serious conditions such as pneumonia or whooping cough, especially if they last longer or worsen.

When Telemedicine Can Help

Telemedicine providers can assess your child's symptoms, offer advice on home care, and recommend over-the-counter treatments when appropriate. They can help determine if symptoms are mild and manageable at home or if further evaluation is needed. Telemedicine is useful for routine follow-up and guidance without needing to leave home.

Red Flags That Need In-Person Care

Certain signs require immediate medical attention:

If any of these occur, seek in-person care promptly.

Preparing for a Telemedicine Visit

Before your telemedicine appointment, have the following ready:

After the Telemedicine Visit

Follow the provider's advice carefully, including any medication instructions. Monitor your child's symptoms closely and watch for any worsening or new red flags. If symptoms do not improve or get worse within the advised timeframe, seek in-person care. Keep emergency numbers handy in case urgent care is needed.

How to prepare for your tele-visit

• Have your child's symptom history ready, including onset and duration.
• Measure and record your child's temperature before the visit.
• Prepare a list of any medications or treatments given.
• Ensure a quiet, well-lit space for the video call.
• Be ready to show your child's breathing and cough if possible.
• Write down any questions or concerns you want to discuss.

After your tele-visit

• Follow the provider’s instructions on medications and care.
• Monitor your child's symptoms closely for changes.
• Watch for any red flags that require urgent care.
• Schedule an in-person visit if symptoms worsen or do not improve.
• Keep emergency contact numbers accessible.
• Contact the telemedicine provider if you have new concerns before the next scheduled check-in.

FAQs

When is a child's cough serious enough to need emergency care?

If your child has trouble breathing, is breathing very fast, has blue lips or face, or is very sleepy or unresponsive, seek emergency care immediately.

Can telemedicine providers prescribe medicines for my child's cough?

Yes, telemedicine providers can often recommend or prescribe medications appropriate for your child's symptoms, but they may advise an in-person visit if prescription medications require physical examination or testing.

How long should I wait before seeking in-person care if my child's cough doesn't improve?

If your child's cough lasts more than 10 days without improvement, or if symptoms worsen at any time, it is important to see a healthcare provider in person for further evaluation.

Can telemedicine diagnose the cause of my child's cough?

Telemedicine can help assess symptoms and suggest possible causes, but some diagnoses require physical exams, tests, or imaging that need to be done in person.

What should I do if my child has a fever with their cough?

Monitor the fever and give fever-reducing medications as advised. If the fever is high (above 38.5°C or 101.3°F) and lasts more than 3 days, or if your child appears very unwell, seek in-person care.

Sources

1. Cough in Children — MedlinePlus, U.S. National Library of Medicine.
2. Cough and Cold in Children: When to See a Doctor — American Academy of Pediatrics.
3. Managing Cough in Children — Centers for Disease Control and Prevention (CDC).
4. Cough — Mayo Clinic.

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical care. If your child's symptoms worsen or you notice any red flags, seek immediate in-person evaluation from a healthcare professional.