Red flags & when to go in person for Panic Symptoms in Children

Audience: pediatric

Panic symptoms in children can be frightening for both the child and their caregivers. These symptoms often include sudden episodes of intense fear, rapid heartbeat, difficulty breathing, and feelings of losing control. While many panic symptoms can be assessed and managed through telemedicine, some situations require immediate in-person evaluation to ensure the child's safety and well-being. This guide helps caregivers understand when telemedicine is suitable and when to seek urgent in-person care. Recognizing red flags such as chest pain, fainting, or severe breathing difficulties is crucial. Early and appropriate care can improve outcomes and provide comfort to children experiencing panic symptoms.

Red flags — go in person / ER

• Chest pain or pressure lasting more than a few minutes — seek emergency care immediately.
• Fainting or loss of consciousness — call emergency services right away.
• Severe difficulty breathing or bluish lips/fingertips — urgent in-person evaluation needed.

What telemedicine can do

• Initial assessment of panic symptoms and anxiety-related concerns.
• Providing guidance on coping strategies and breathing exercises.
• Medication management and follow-up for known anxiety disorders.
• Education and support for caregivers on managing panic symptoms.

What telemedicine cannot do

• Emergency symptoms such as chest pain, fainting, or severe breathing difficulty.
• Physical examination required to rule out other medical conditions.
• Situations requiring immediate interventions or hospital admission.

Understanding Panic Symptoms in Children

Panic symptoms may include sudden fear, rapid heartbeat, sweating, trembling, shortness of breath, chest discomfort, dizziness, or a feeling of losing control. These symptoms can be very distressing but are often not caused by a physical illness. Children may have difficulty explaining what they feel, so caregivers should observe behaviors closely. Panic symptoms can sometimes be mistaken for other medical problems, so careful assessment is important.

When Telemedicine Can Help

Telemedicine allows caregivers and children to consult healthcare providers remotely. It is useful for discussing symptoms, getting advice on managing panic attacks, and receiving guidance on coping strategies. Providers can help identify if symptoms are typical of panic or if further evaluation is needed. Telemedicine can also support ongoing mental health care and medication management when appropriate.

Red Flags That Require In-Person Care

Some symptoms require urgent in-person evaluation to rule out serious conditions:

If any of these occur, seek emergency care immediately.

Preparing for a Telemedicine Visit

Before the tele-visit, gather important information:

After the Telemedicine Visit: What to Expect

After the visit, follow the healthcare provider's recommendations carefully. This may include:

Keep a symptom diary to share during future visits.

How to prepare for your tele-visit

• Note the child's symptoms, including onset, duration, and frequency.
• List all current medications and any allergies.
• Prepare specific questions or concerns to discuss.
• Ensure a quiet, private space with reliable internet connection for the visit.
• Have a responsible adult available to assist the child during the tele-visit.

After your tele-visit

• Follow healthcare provider's advice on symptom management.
• Monitor the child's symptoms and note any changes.
• Use recommended coping techniques or medications as directed.
• Schedule any follow-up appointments as advised.
• Seek immediate in-person care if any red flags develop or symptoms worsen.

FAQs

Can telemedicine diagnose panic attacks in children?

Telemedicine can help healthcare providers assess symptoms and suggest if they are likely related to panic attacks. However, a full diagnosis may require in-person evaluation, especially to rule out other causes.

What should I do if my child has a panic attack during a telemedicine visit?

Stay calm and help your child use breathing or relaxation techniques suggested by the provider. If symptoms worsen or red flags appear, seek emergency care immediately.

Are panic symptoms dangerous in children?

While panic symptoms themselves are not usually dangerous, they can be very distressing. It is important to rule out other medical conditions and to seek care if severe symptoms or red flags occur.

How can I help my child manage panic symptoms at home?

Encourage slow, deep breathing, provide reassurance, and create a calm environment. Avoid forcing the child to talk if they are overwhelmed. Follow any specific strategies recommended by your healthcare provider.

Sources

1. Panic Disorder in Children and Adolescents — American Academy of Child & Adolescent Psychiatry (AACAP).
2. Panic Attacks and Panic Disorder — MedlinePlus, U.S. National Library of Medicine.
3. Anxiety and Panic Disorders — Centers for Disease Control and Prevention (CDC).
4. Anxiety Disorders in Children — American Academy of Pediatrics (AAP).

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for professional in-person medical evaluation, diagnosis, or treatment. If your child experiences any emergency symptoms or if you are concerned about their health, seek immediate in-person care.