Nine on a Sunday night, a child who’s been fine all day and is now not fine, and what you need to work out isn’t what’s wrong with them. It’s where to take them.
Get this wrong towards caution and you spend four hours in an emergency department for something a GP would have handled in ten minutes, at several times the cost. Get it wrong the other way and you wait out something that needed seeing.
Go straight to a children’s emergency department, or call 995, for any of these:
- Difficulty breathing: fast breathing, the skin pulling in between or under the ribs, grunting, or blue lips
- A fit or seizure, or a child who’s unusually drowsy, floppy, or can’t be roused properly
- Any fever in a baby under three months
- A rash that doesn’t fade when you press a glass against it, particularly with fever
- A stiff neck with fever, or severe headache with light hurting their eyes
- Signs of serious dehydration: no urine for many hours, sunken eyes, no tears, unusually still
- A head injury followed by vomiting, drowsiness or confusion
- Suspected poisoning, or a swallowed button battery, which is a real emergency
- A severe allergic reaction: swelling of the face or tongue, breathing difficulty, collapse
None of these are wait-and-see situations, and none of them are a GP visit.
What each option is for
| Where | Best for | The trade-off |
|---|---|---|
| Your GP | The great majority of childhood illness: fever, cough, sore throat, rash, ear pain, stomach upsets, minor injuries. | Limited hours. Check which nearby clinics open late or on Sundays. |
| Polyclinic | Routine care, vaccinations, follow-ups, and situations where cost is the deciding factor. | Heavily subsidised but long waits, and daytime hours on weekdays. |
| After-hours GP clinic | Evenings and weekends, for things that can’t wait until Monday but aren’t emergencies. | Costs more than daytime, still far less than an emergency department. |
| Paediatrician | Ongoing conditions, developmental concerns, or a child whose history is complicated. | Appointment-based, so rarely the answer at 9pm. |
| Children’s emergency | The list above. Serious breathing problems, seizures, unresponsiveness, serious injury. | Open around the clock, triaged by severity, expensive, and slow if your child isn’t seriously unwell. |
| 995 | Life-threatening situations, or a child who can’t safely be moved by car. | None. If it’s that serious, call. |
Why the emergency department is slow for you
Emergency departments see patients in order of how sick they are, not in order of arrival. That’s the correct way to run one, and it’s precisely why bringing a child with a mild fever means watching people who arrived after you go in first, for hours.
The other half is cost. An emergency attendance that doesn’t result in admission is much more expensive than a GP visit, and subsidies work differently there.
This isn’t an argument against going. It’s an argument for going when the list above applies, and for having a plan for the other nights.
What to do before you need it
The decision is far easier when it isn’t being made from scratch at 9pm with a crying child.
- Find the late-opening and Sunday clinics near you now, and put them in your phone.
- Know which children’s emergency you’d go to and how long it takes from your home.
- Keep a working thermometer and know your child’s usual weight. You’ll be asked.
- Keep the health booklet somewhere you can find in the dark.
- Know whether your GP answers messages out of hours. Many will, and one message can save an entire evening.
When it isn’t clear
Most nights aren’t on the emergency list and not obviously fine either. A few things that help:
How a child looks between fevers tells you more than the number on the thermometer. A child who perks up when the paracetamol takes effect, drinks something and wants a story is a reassuring picture. A child who stays limp and uninterested even when the fever comes down is a more concerning one, whatever the reading says.
Watch fluids, not food. Children go off eating when unwell and that’s expected; not drinking, and not producing wet nappies or urine, is the warning sign.
And there’s a version of this that isn’t medical at all: if your instinct says something is wrong with your child, that instinct has a decent track record. Act on it. Parents are usually right that something is off, even when they can’t say what.
Frequently asked questions
When should I take my child to the emergency department?
For difficulty breathing, a seizure, unusual drowsiness or floppiness, any fever in a baby under three months, a rash that doesn’t fade under pressure, a stiff neck with fever, serious dehydration, a head injury with vomiting or drowsiness, suspected poisoning, or a severe allergic reaction. Call 995 if the situation is life-threatening or the child can’t safely be moved.
Is it better to go to a GP or a polyclinic?
A GP is faster and usually closer; a polyclinic is cheaper. Both handle ordinary childhood illness. For an evening or weekend problem, an after-hours GP clinic is generally the practical answer.
Why did we wait so long at the children’s emergency?
Because patients are seen by severity, not arrival time. A long wait usually means your child was assessed as not seriously unwell, which is reassuring even though it doesn’t feel that way at the time.
My child has a high fever. Is that an emergency by itself?
Not usually, in a child over three months who’s otherwise responsive and drinking. How they look between fevers matters more than the number. Any fever in a baby under three months is different and needs same-day medical attention.
What if I’m not sure?
Err towards being seen, and towards the emergency department for anything on the red-flag list. For everything else a call to a GP or clinic will usually settle it, and a parent’s instinct that something is wrong deserves to be taken seriously.
What to remember
Breathing trouble, seizures, a floppy or unrousable child, fever under three months old, a rash that won’t blanch: emergency department or 995, without debating it.
Nearly everything else is a GP, and on a Sunday night an after-hours clinic. Find those clinics before you need them.
And watch the child, not the thermometer. How they look between fevers tells you more.
Read next
- Febrile seizures: first aid
- Meningitis in children: the signs
- Choking: why grapes need cutting lengthwise
This article is general information and not a substitute for medical advice. If you think your child is seriously unwell, seek medical care immediately or call 995.