Tele-triage for Hives in Children

Audience: pediatric

Hives, also known as urticaria, are raised, itchy red or skin-colored welts that can appear suddenly on a child's skin. They often result from allergic reactions, infections, or other triggers. Telemedicine can help assess mild to moderate hives by reviewing symptoms, possible causes, and treatment options. However, some situations require urgent in-person care, especially if the child has difficulty breathing, swelling of the face or throat, or a rapidly spreading rash. During a tele-visit, healthcare providers can guide caregivers on managing symptoms, avoiding triggers, and when to seek emergency help. This approach helps families get timely advice while reducing unnecessary clinic visits. Always monitor the child's condition closely and follow healthcare advice carefully.

Red flags — go in person / ER

• Difficulty breathing, wheezing, or tightness in the throat — seek emergency care immediately.
• Swelling of the face, lips, tongue, or throat — call emergency services right away.
• Dizziness, fainting, or rapid heartbeat alongside hives — get urgent medical help.

What telemedicine can do

• Assessment of mild to moderate hives without breathing difficulty.
• Guidance on symptom management and medication use.
• Advice on avoiding triggers and monitoring symptoms.

What telemedicine cannot do

• Severe allergic reactions with breathing problems or swelling.
• Rapidly spreading rash with systemic symptoms like fever.
• Any signs of anaphylaxis or shock requiring emergency intervention.

What Are Hives?

Hives are raised, itchy bumps or welts that appear on the skin. They can vary in size and shape and often change location over hours. In children, hives may be caused by allergies to foods, medications, insect bites, infections, or other triggers. The rash usually comes on quickly and may last from a few hours to several days.

When to Use Telemedicine for Hives

Telemedicine is a good option if your child has hives without other serious symptoms. A healthcare provider can ask about the rash, possible triggers, and other symptoms. They can suggest treatments like antihistamines and advise on avoiding triggers. Tele-triage helps decide if home care is enough or if an in-person visit is needed.

Signs That Need In-Person Care Immediately

Seek urgent medical attention if your child has:

These signs may indicate a serious allergic reaction requiring emergency treatment.

Managing Hives at Home

For mild hives, you can:

Monitor the rash and any new symptoms closely.

Preparing for a Telemedicine Visit

Before the tele-visit, prepare by:

This information helps the provider assess your child's condition accurately.

After the Telemedicine Visit

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

Keep a record of the tele-visit notes for future reference.

How to prepare for your tele-visit

• Take clear photos of the hives from different angles.
• Note the time when hives first appeared.
• List any possible triggers or recent exposures.
• Record other symptoms your child may have.
• Prepare a list of current medications and allergies.
• Find a quiet, well-lit place for the tele-visit.

After your tele-visit

• Administer any recommended medications as directed.
• Monitor your child for new or worsening symptoms.
• Follow advice on avoiding known triggers.
• Schedule an in-person visit if symptoms do not improve or worsen.
• Seek emergency care immediately if red flag symptoms appear.

FAQs

What causes hives in children?

Hives can be caused by allergic reactions to foods, medications, insect bites, infections, or other triggers. Sometimes the exact cause is not found.

Can hives be serious?

Most hives are mild and go away on their own or with treatment. However, if hives come with difficulty breathing, swelling of the face or throat, or dizziness, it can be serious and needs emergency care.

How can I relieve my child's itching?

Cool compresses and antihistamines (as advised by a healthcare provider) can help reduce itching. Avoid scratching to prevent skin damage.

When should I seek in-person care for hives?

Seek in-person or emergency care if your child has trouble breathing, swelling of the face or throat, dizziness, or if the rash spreads quickly with fever.

Can telemedicine providers prescribe medication for hives?

Yes, telemedicine providers can often recommend or prescribe medications like antihistamines if appropriate based on the assessment.

Sources

1. Urticaria (Hives) — MedlinePlus, U.S. National Library of Medicine.
2. Hives (Urticaria) — Mayo Clinic.
3. Allergic Reactions and Anaphylaxis — Centers for Disease Control and Prevention (CDC).
4. Urticaria (Hives) in Children — American Academy of Pediatrics.

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 medical attention.