Mercy pediatrician offers guidance on respiratory illness & when to go to the ER
Respiratory viruses, including flu and RSV (respiratory syncytial virus), are circulating rapidly across the country. They’re hitting our pediatric population especially hard, along with other respiratory viruses, such as SARS-CoV-2, enterovirus D68, parainfluenza and rhinovirus. The combination of the severity of the RSV strain this year – along with so many other viral infections – is causing many children to be extremely sick, putting extra pressure on hospitals and causing concern among parents of young children.
The Centers for Disease Control and Prevention warns that an outbreak of respiratory illnesses, especially RSV, has come earlier than normal this year and is putting a strain on both emergency rooms and inpatient pediatric hospital units.
Padget Skogman, MD, pediatric hospitalist at Mercy Cedar Rapids, says most children who get sick this season will be able to recover at home, but professional medical attention or hospitalization may be needed for others, especially if they have other medical conditions.
Dr. Skogman offers this information and guidance:
What symptoms should parents watch for that could indicate a respiratory infection?
Dr. Skogman: “For many, RSV causes a mild illness that can be managed at home. RSV symptoms can be expected to last one to two weeks. Symptoms start mildly and typically progress to their most severe peak on days four and five of illness. Sometimes, the cough can linger for up to a month. Symptoms may be similar to a common cold: a runny nose, decreased appetite, coughing, sneezing, fever and wheezing. Young infants may seem irritable or lethargic and have trouble breathing. Children may also wheeze and develop a cough.”
What warning signs do you look for indicating it might be time to go to the hospital?
Dr. Skogman: “It’s important to watch for signs that your child is struggling to breathe or if breathing is pulling at their ribs and/or using all their muscles to breathe. Flaring of the nostrils and audible grunting during breathing are additional warning signs. This type of labored breathing is a sign that a child is having trouble with the virus, and they should be seen in by their doctor, in an urgent care or emergency room.
“Also, if a child is unable to keep fluids or feedings down; experiences very fast labored breathing that’s making them tired; or a baby less than two months old has a fever, it’s time to act. Children showing these signs of respiratory distress should go to the emergency room.”
When should parents take their children to see a doctor?
Dr. Skogman: “Make sure your child is drinking enough fluids. RSV can make them very dehydrated. If a child stops eating or their urine output has decreased significantly, this is a sign to go to the doctor.”
“Place a call to your child’s doctor if:
- Your child is having less than half of their normal urine output (or wet diapers).
- Your baby is younger than three months old and has a fever higher than 100.4°F, or 38°C.
- Your child is older than three months and has a fever (temperature higher than 100.4°F, or 38°C) for more than three to four days.”
What can parents do for their children at home when illness is not severe?
Dr. Skogman: “Here is some guidance I provide to my patients:
- Fever and pain can be managed with non-aspirin pain relievers, like ibuprofen or acetaminophen. Remember that the fever itself is helpful for the body to fight the virus.
- To help with mucus removal, use suction and/or saline spray, especially before a feeding.
- Keep your child hydrated. Try to have them continue to drink frequent, small volumes of liquid, such as Pedialyte, formula (for those less than 12 months old) or water. Pedialyte and/or milk if older than 12 months.
- You may use a humidifier to keep the air moist in the room where your child sleeps.
“I always encourage parents to make sure their children are washing hands, covering their coughs and staying home when sick. It’s also important to stay up-to-date on immunizations, including COVID-19 and influenza.”
At what age are RSV or other respiratory illnesses most severe?
Dr. Skogman: “When it comes to RSV, parents should be especially cautious if their children are preemies, newborns, children with weakened immune systems or neuromuscular disorders, and those under the age of two with chronic lung or heart conditions.”
