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Your child has a fever, but when is it time to go to the ER?

Woman checking daughter's temperature. (Orlando Health)

When your child isn’t feeling well and has a fever, it’s easy to fixate on the thermometer’s reading.

How high is too high? Is it better to take them to the emergency room or to treat the fever at home?

A normal body temperature is 98.6 degrees. A temperature of 100.4 degrees and higher is defined as a fever. In general, a temperature of 101 degrees or lower is a low-grade fever, and a high fever is 102 degrees or higher.

While a high fever isn’t indicative of how sick your child is, there are some signs to look for to help you decide if it’s time to take your child to the hospital.

What childhood illnesses cause fever?

A fever itself generally does not cause harm and is a sign the body is fighting an infection. Conditions that can cause fever in children are:

  • Common cold
  • Ear infection
  • Flu
  • Kidney or urinary tract infections (UTIs)
  • Stomach bug (particularly in small children)
  • Strep throat
  • Viral rashes, such as roseola

A high fever doesn’t always mean there’s a serious problem. It’s important to look for other symptoms that accompany the fever, in order to determine whether medical attention is required.

Letting fever “run its course”

The latest recommendations from medical experts are to allow the fever to “run its course,” if your child is active and playful and is drinking and eating normally.

If your child appears uncomfortable, you may want to treat the fever with acetaminophen (Tylenol) or ibuprofen (Motrin). Acetaminophen is FDA approved for children 2 months of age and older, and ibuprofen is approved for children 6 months of age and older.

When to head to the ER

Fever alone usually is not reason enough to head to the ER, but there are other things to look for when deciding to seek medical attention.

Seek emergency care if your child shows any of these signs:

  • Blue lips, tongue or nails
  • Constant crying
  • Refuses fluids or is too sick to drink adequately
  • Experiences a febrile seizure (seizure brought on by high body temperature)
  • Has signs of dehydration (urinating less frequently, no tears when crying)
  • Limpness/inability to move
  • Moderate to severe stomach pain
  • Sluggishness or trouble waking
  • Stiff neck
  • Trouble breathing or fast breathing
  • Rash or purple spots that look like bruises

If your child has a fever, but does not show any of the listed emergency signs, consider treating them at home, seeing your child’s primary health care provider or going to a walk-in clinic.

It is possible your child could have a viral or bacterial infection that requires treatment but doesn’t need an ER visit. Remember: Your child’s behavior is more important than the number on the thermometer. Most fevers can be cared for at home. With plenty of fluids and rest, they should be feeling better within a few days.

How to take an accurate temperature

The most accurate way to take a child’s temperature is by using a rectal thermometer.

Many parents are unsure how to use a rectal thermometer, so instead, they use the type that swipes across the forehead, also called a temporal artery thermometer. These thermometers read heat waves coming from a blood vessel that runs across the forehead, just below the skin.

A temporal artery thermometer should be placed at the center of your child’s forehead. Slowly slide it across the forehead toward the top of your child’s ear, keeping the thermometer in contact with the skin. Stop when you reach the hairline, then read your child’s temperature on the display screen.

Some newer models of forehead thermometers do not require you to slide them across the forehead for an accurate reading.


For 12 years straight, Orlando Health Arnold Palmer Hospital For Children has been recognized as a “Best Children’s Hospital” by U.S. News & World Report, and we are dedicated to sharing our expertise with you.


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