Guidance for parents with an unwell or injured child during the Coronavirus (COVID-19) pandemic

We are thankful for the support of our community by staying at home during coronavirus (COVID-19). However our paediatric team are asking parents and carers to make sure they seek medical advice as soon as it’s needed for their children.

Whilst it is extremely important to follow the Government advice, it can be confusing to know what to do when your child is acutely unwell or injured. To help with this the Royal College of Paediatricians and Child Health have put together some guidance for parents during coronavirus (COVID-19).

Please also remember that the usual NHS services such as pharmacists, GP’s, urgent care centres, NHS 111 and accident and emergency, are all still here for you.
NHS 111 can provide free urgent advice online or over the phone.

You should go to the nearest A&E department or phone 999, if your child has any of the following:
• Becomes pale, mottled and feels abnormally cold to the touch. 
• Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting.
• Severe difficulty in breathing becoming agitated or unresponsive. 
• Is going blue round the lips. 
• Has a fit/seizure. 
• Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive.
• Develops a rash that does not disappear with pressure (the ‘Glass test’).
• Has testicular pain, especially in teenage boys.

You should ring your GP surgery or call NHS 111 today if your child has any of the following:
• Is finding it hard to breathe including drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession) or head bobbing.
• Seems dehydrated (dry mouth, sunken eyes, no tears, drowsy or passing less urine than usual).
• Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down.
• Has extreme shivering or complains of muscle pain.
• Babies under 3 months of age with a temperature above 38°C / 100.4°F.
• Infants 3-6 months of age with a temperature above 39°C / 102.2°F.
• For all infants and children with a fever above 38°C for more than 5 days.
• Is getting worse or if you are worried. 
• Has persistent vomiting and/or persistent severe abdominal pain. 
• Has blood in their poo or wee.
• Any limb injury causing reduced movement, persistent pain or head injury causing persistent crying or drowsiness.

If none of the above features or symptoms are present, you can provide your child's care at home. If you are still concerned about your child, call NHS 111:
• You can continue to provide your child care at home. Information is also available on nhs.uk.
• Additional advice is available to families for coping with crying of well babies.
• Additional advice is available for children with complex health needs and disabilities.

To get help from NHS 111, you can:

• go to 111.nhs.uk  (for people aged 5 and over only)
• call 111

NHS 111 is available 24 hours a day, 7 days a week. If you use british sign language, you can access the 24/7 British Sign Language Interpreter 111 service.