Red Flags & When to Go In Person for Ear Pain in Children

Audience: pediatric

Ear pain in children is a common symptom that may be caused by infections, injuries, or other conditions. Telemedicine can help evaluate mild to moderate ear pain by discussing symptoms, visual examination if possible, and guiding home care. However, some signs indicate the need for in-person medical care to ensure proper diagnosis and treatment. Recognizing these red flags can help parents and caregivers decide when to seek urgent or emergency care. This article explains when telemedicine visits are appropriate for pediatric ear pain and when to go to a healthcare facility in person for further evaluation.

Red flags — go in person / ER

• Severe or worsening ear pain not relieved by home treatment — seek prompt in-person evaluation.
• High fever (above 39°C or 102°F) lasting more than 48 hours — seek medical care.
• Ear drainage that is thick, colored, or bloody — requires urgent medical assessment.

What telemedicine can do

• Mild to moderate ear pain without severe symptoms
• Symptom assessment and guidance on home care
• Determining need for in-person evaluation

What telemedicine cannot do

• Severe ear pain requiring physical examination
• Ear drainage needing direct inspection and possible treatment
• Signs of complications such as hearing loss, balance problems, or facial swelling

Common Causes of Ear Pain in Children

Ear pain in children often results from ear infections such as otitis media (middle ear infection) or otitis externa (outer ear infection). Other causes include earwax buildup, injury, teething, or referred pain from the throat or sinuses. Symptoms may include ear discomfort, pulling at the ear, fever, irritability, or difficulty hearing.

When Telemedicine Can Help

Telemedicine is useful for assessing mild or moderate ear pain when your child is stable and symptoms are not severe. A healthcare provider can ask about symptoms, observe the ear if video is available, and recommend treatments such as pain relief, warm compresses, or monitoring. Telemedicine can also guide when to seek further care.

Red Flags That Require In-Person Care

Certain signs mean your child should be seen in person promptly or urgently:

Preparing for a Telemedicine Visit

Before your telemedicine appointment, gather the following:

After the Telemedicine Visit

Follow the healthcare provider's advice carefully. This may include giving pain relievers, monitoring symptoms, or scheduling an in-person visit if needed. Watch for any worsening symptoms or new red flags. If symptoms worsen or red flags develop, seek in-person care immediately.

How to prepare for your tele-visit

• Note the start time and progression of ear pain and other symptoms.
• Check and record your child's temperature.
• Prepare a device with video capability to show the child's ear if possible.
• Have a list of current medications and allergies ready.
• Find a quiet, well-lit space for the appointment.
• Write down any questions or concerns to discuss with the provider.

After your tele-visit

• Follow the provider’s recommendations for medications or home care.
• Monitor your child’s symptoms closely for improvement or worsening.
• Seek in-person care if red flags or new symptoms develop.
• Schedule follow-up appointments as advised.
• Keep a record of any changes in symptoms or new concerns to report later.

FAQs

Can telemedicine diagnose an ear infection in my child?

Telemedicine can help assess symptoms and guide care, but it often cannot fully diagnose an ear infection without a physical examination and use of an otoscope. If diagnosis is uncertain or symptoms are severe, in-person evaluation is recommended.

What should I do if my child has ear pain and a fever?

If the fever is mild and your child is otherwise well, you can start home care and consult via telemedicine. However, if the fever is high (above 39°C or 102°F), lasts more than 48 hours, or your child appears very unwell, seek in-person medical care promptly.

Is it safe to give my child pain relievers for ear pain?

Yes, age-appropriate doses of acetaminophen or ibuprofen are generally safe to relieve ear pain. Always follow dosing instructions and check with a healthcare provider if you have concerns.

When should I take my child to the emergency room for ear pain?

Go to the emergency room if your child has severe ear pain with high fever, swelling around the ear or face, difficulty breathing, severe headache, dizziness, or if they are very lethargic or unresponsive.

Can ear pain be a sign of something serious?

While many cases of ear pain are due to common infections, sometimes it can indicate complications or other serious conditions. Watch for red flags and seek in-person care if you are concerned.

Sources

1. Ear Infection (Otitis Media) — MedlinePlus, U.S. National Library of Medicine.
2. Ear Pain in Children — American Academy of Pediatrics (AAP).
3. Otitis Media — Centers for Disease Control and Prevention (CDC).
4. Ear Pain — Mayo Clinic.

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