It’s 9pm. Your child has a fever. They’re not quite right. Your gut is telling you something — but you’re not sure if that something warrants a trip to the emergency department or if this can wait until tomorrow morning for a GP appointment.
Every parent knows this feeling. And almost every parent gets it wrong at some point — either sitting in an emergency waiting room for four hours for something that turned out to be fine, or waiting too long at home for something that really needed urgent attention.
This guide gives you a practical, Australia-specific framework for making that decision. It covers common childhood symptoms, the signs that mean go immediately, and the signs that mean a GP appointment is the right call.
The Most Important Rule: Always Trust Your Instincts
Before the lists and the categories — the most important thing to know is this: if you genuinely feel that your child is seriously unwell, trust that feeling and seek care immediately.
Parents know their children. You know what “normal” looks like for your child — their usual energy level, their typical response to illness, the way they behave when they’re just a bit off vs. when something is really wrong.
If your child seems seriously ill to you, even if their symptoms don’t neatly fit an emergency category, go to the emergency department or call 000. No triage nurse or doctor will judge you for bringing a child in who turns out to be okay. That is always the right call when you’re genuinely concerned.
Also available: Victoria’s NURSE-ON-CALL service (1800 022 222) is a free 24/7 nurse helpline that can help you decide whether a symptom requires emergency care, a GP visit, or can be managed at home. It is a genuinely useful first resource when you’re unsure.
Call 000 Immediately For:
These symptoms in a child are always emergencies. Do not drive to hospital yourself — call 000 for an ambulance.
- Not breathing, or struggling significantly to breathe — breathing that is laboured, very fast, noisy, or involves the ribs or neck muscles visibly working with each breath
- Blue or grey colour around the lips or fingernails (cyanosis) — a sign of dangerously low oxygen
- Unresponsive, unconscious, or impossible to wake
- A seizure (fit) that is still going on — or a first seizure that has stopped but the child has not fully recovered
- Severe allergic reaction — swelling of the lips, tongue, or throat, difficulty swallowing, or hives combined with breathing difficulty
- Severe head injury — especially if followed by loss of consciousness, vomiting, confusion, or seizure
- Suspected ingestion of poison, medication, or a dangerous substance
- Major injury — significant burns, suspected broken bones with deformity, deep wounds with uncontrolled bleeding
Go to Emergency Immediately (Or Call 000 if Uncertain) For:
Fever in a baby under 3 months old: If you have a baby under 3 months old with a fever above 38°C, take them to the nearest hospital emergency department immediately. Young infants have immature immune systems and cannot fight serious infection the way older children can. A fever at this age must always be investigated urgently — do not wait for a GP appointment.
Fever in an infant 3–12 months with concerning features: While it is less urgent than in a baby under 3 months, a fever in an infant aged 3–12 months still warrants same-day medical assessment — either at your GP if they can see you urgently, or at emergency if not. Signs that make this more urgent include: high fever (above 39°C), a fever lasting more than 24 hours, irritability, excessive crying, difficulty waking, or refusing feeds.
A non-blanching rash — the glass test: Press a clear glass firmly against a rash. If the rash does not fade under pressure, this is potentially a sign of meningococcal disease or septicaemia, which can be life-threatening. Call 000 or go to emergency immediately. Do not wait to see if it gets better.
Meningitis warning signs: Severe headache, stiff neck, sensitivity to light, vomiting, and a non-blanching rash together — or any combination that seems consistent with meningitis — requires immediate emergency care.
Difficulty breathing — any child who is working hard to breathe, breathing very fast, making unusual sounds when breathing (stridor or wheeze), or whose lips are pale or blue requires emergency care. This applies even if the child has asthma and has used their reliever — if their breathing does not improve after reliever use, go to emergency.
Severe abdominal pain — sudden onset of severe abdominal pain, particularly if accompanied by vomiting, rigidity of the abdomen, or signs of pallor and distress, warrants emergency assessment. Causes requiring urgent surgery (appendicitis, intussusception, bowel obstruction) must be excluded.
Severe dehydration — signs include: no wet nappies or no urination for 8+ hours, dry mouth and lips with no tears when crying, sunken eyes or fontanelle (soft spot) in babies, extreme lethargy, and skin that remains “tented” when pinched. A child who cannot keep any fluids down and is showing signs of dehydration needs emergency assessment.
A seizure (fit) that has stopped — even if a febrile seizure (convulsion triggered by fever) has fully resolved, a child who has had their first-ever seizure should be assessed at emergency the same day. Children who have had a known febrile seizure and have returned to their normal self quickly may be able to see their GP instead — discuss this with your doctor in advance so you have a plan.
Head injury with warning signs — if your child has hit their head and develops any of the following, go to emergency: loss of consciousness (even briefly), repeated vomiting (more than once), severe headache that doesn’t improve, abnormal drowsiness, unusual behaviour or confusion, weakness or numbness, or a seizure.
Swallowed a foreign object or battery — button batteries in particular are extremely dangerous if swallowed, as they can cause severe burns to the oesophagus within 2 hours. This is always an emergency.
Child with a known condition who suddenly deteriorates — a child with asthma whose reliever isn’t working, a child with diabetes whose blood glucose is very high or very low and not responding to treatment, or a child with epilepsy having an unusual or prolonged seizure: all warrant emergency care.
See Your GP Urgently (Same Day) For:
Fever in a child over 12 months with no concerning features — most fevers in older children are caused by viral infections and are managed at home with rest, fluids, and paracetamol or ibuprofen (not aspirin). However, see your GP the same day if:
- The fever is very high (above 39.5°C) and not responding to paracetamol or ibuprofen
- The fever has lasted more than 3 days without improving
- Your child seems very unwell, lethargic, or is not behaving like themselves
- You cannot identify a clear cause for the fever
- Your child also has a rash, ear pain, sore throat, or other localised symptoms worth examining
Ear pain — ear infections are extremely common in children and very painful. A child pulling at their ear, crying with ear pain, or with discharge from the ear should see a GP for assessment. Antibiotics are not always needed — your GP will assess whether this is bacterial or viral — but an examination is important.
Sore throat — most sore throats are viral and resolve with rest and fluids. See your GP if your child’s sore throat is severe, they are having difficulty swallowing, the pain is not improving after 3–4 days, or there is a visible coating or pus on the tonsils. Streptococcal throat infection (strep throat) needs antibiotic treatment and should not be left unassessed.
Croup — a barking, seal-like cough typically worse at night, often accompanied by a harsh sound when breathing in (stridor). Mild croup can usually be managed at home with cool night air and keeping the child calm. If the stridor is present at rest, the child is struggling to breathe, or symptoms are severe or worsening, go to emergency. For mild-to-moderate croup that has settled but you want reviewed — your GP can assess and prescribe steroid medication if appropriate.
Vomiting and diarrhoea (gastroenteritis) — most cases resolve with careful fluid management at home. See your GP if:
- The child is under 6 months old
- Vomiting or diarrhoea has persisted for more than 24–48 hours without improvement
- You are seeing signs of dehydration (see above)
- There is blood in the stool or vomit
- Your child cannot keep any fluid down for more than 6–8 hours
Eye discharge, redness, or swelling — conjunctivitis (pink eye) is common and usually mild. A GP can assess whether it is viral or bacterial, and prescribe antibiotic eye drops if needed. If the eye is significantly swollen, the child is in significant pain, or there is swelling of the area around the eye (not just the eyelid), this warrants urgent assessment.
Rash without other serious features — rashes in children are extremely common and usually benign. If a rash has no concerning features (does not blanch — do the glass test first — child is well in themselves, no fever or other signs of serious illness), see your GP rather than emergency. Your GP can assess the likely cause and advise on management.
Limping or refusing to use a limb — a child who is limping or not using an arm or leg should be seen by a GP. The cause may be minor (a soft tissue injury, growing pains), but some causes require urgent treatment (bone or joint infection, fracture, septic arthritis). Fever combined with limping warrants urgent assessment as the causes can be quite serious, such as bone or joint infections.
Head injury without warning signs — if your child has had a mild bump to the head, is fully alert and behaving normally, has not vomited more than once, and has no loss of consciousness, they can generally be monitored at home and seen by a GP if you remain concerned. Signs that warrant emergency: see above.
What Can Usually Be Managed at Home (With or Without a GP Call):
- Common cold — runny nose, mild cough, low fever, general unwellness. Most colds resolve within 7–10 days with rest and fluids. See your GP if symptoms worsen significantly after day 5, or if you’re concerned.
- Mild fever in a child over 12 months who is otherwise well — rest, fluids, and paracetamol or ibuprofen (appropriate dose for weight). Do not use aspirin in children.
- Mild gastroenteritis in an older child without dehydration — small, frequent sips of fluid (oral rehydration solution for young children, water or diluted juice for older ones), bland food when tolerated, rest.
- Nappy rash — barrier creams and keeping the area dry. See your GP if it’s not improving or if you’re concerned about thrush.
- Teething — discomfort, drooling, gum rubbing. Teething gels or chilled teething rings can help. Teething does not cause fever above 38°C — if your teething baby has a genuine fever, it has another cause and may need assessment.
A Practical Age-Based Guide to Fever in Children
Fever is the most common reason parents seek emergency care for their child. Here’s a straightforward guide:
| Child’s Age | What to Do |
|---|---|
| Under 3 months, fever above 38°C | Go to emergency immediately |
| 3–12 months, fever with any concerning features | Same-day GP or emergency |
| 3–12 months, fever, child well in themselves | Same-day GP review |
| Over 12 months, fever, child well in themselves | Monitor at home; GP if not improving in 2–3 days |
| Any age, fever with rash that doesn’t blanch | Emergency immediately |
| Any age, fever with difficulty breathing, severe headache, stiff neck, or confusion | Emergency immediately |
| Any age, fever above 40°C not responding to medication | Same-day GP or emergency |
Remember: it is normal for children to have between 5 and 10 infections per year, and children in day care have approximately twice as many infections as those who don’t attend. Frequent illnesses in a healthy child who recovers well are usually not a cause for concern.
Common Symptoms Parents Worry About (But That Are Usually Not Emergencies)
High fever number alone — parents often believe a very high fever number (39°C, 40°C) means something is very wrong. In most children, the height of the fever does not reliably indicate the seriousness of the illness. What matters more is how the child looks and behaves. A child with a 40°C fever who is alert, drinking, and interactive is usually less concerning than a child with a 38.5°C fever who is limp and difficult to rouse.
Febrile seizure — approximately 2–4% of children have at least one febrile seizure before age 6. They are frightening to witness but in the vast majority of cases are not dangerous and do not cause brain damage. A febrile seizure usually lasts less than 5 minutes, involves the child becoming stiff or jerking, then becoming very sleepy. If it is the child’s first seizure, go to emergency. If your child has had febrile seizures before and this one is typical of their previous ones, discuss with your GP in advance what the recommended management is for your child.
Cough — a hacking cough is distressing to watch but in most children is not an emergency. Cough is extremely common in childhood and usually resolves on its own. An exception: a cough in a baby under 3 months (particularly a whooping cough-like cough) and a cough that causes significant breathing difficulty should always be assessed.
Vomiting once or twice — vomiting once or twice with a viral illness is very common and not usually a sign of serious illness. Repeated vomiting (more than 3–4 times per hour), vomiting with severe abdominal pain, or vomiting in a very young baby are different and warrant assessment.
How the Emergency Department Triage System Works
Understanding how triage works can help manage your expectations when you go to emergency.
When you arrive at emergency with a child, a triage nurse will assess your child’s condition and assign a category:
- Category 1 (Immediately life-threatening) — seen immediately
- Category 2 (Emergency) — seen within 10 minutes
- Category 3 (Urgent) — seen within 30 minutes
- Category 4 (Semi-urgent) — seen within 1 hour
- Category 5 (Non-urgent) — seen within 2 hours
If your child is assigned Category 4 or 5 and you’re waiting for an extended period, this is because children with more urgent needs are being seen first — not because your child’s condition is being ignored. If your child’s condition changes while you are waiting, always go back to the triage nurse immediately.
When to Use the NURSE-ON-CALL Line (Victoria)
Victoria’s NURSE-ON-CALL service (1800 022 222) is a free, 24/7 telephone service staffed by registered nurses who can help you assess whether a symptom requires emergency care, a GP visit, or home management. It is not a substitute for emergency care when your child is seriously unwell — but for situations where you are genuinely uncertain, it is an excellent first resource.
You can call NURSE-ON-CALL at any time of day or night, including weekends and public holidays.
Your GP as a Partner in Children’s Health
Your GP’s role in your child’s health extends well beyond sick visits. Regular health checks — including the scheduled child health checks offered in Australia (including the 4-year-old developmental check) — track growth, development, hearing, vision, and immunisation status, and give you an ongoing relationship with a practitioner who knows your child.
Having an established relationship with a GP also means that when your child does become unwell, you have a trusted point of contact who knows your child’s history and can give you advice specific to them.
At Central Health Clinic in Sunshine, our GPs see children of all ages and work as partners with families in keeping kids healthy — from routine immunisations and development checks to acute illness management and specialist referrals when needed.
Frequently Asked Questions
When should I take my child to emergency for a fever? Take a baby under 3 months to emergency immediately for any fever above 38°C. For children 3–12 months with a fever and concerning features (high fever, lethargy, refusing feeds, rash), seek same-day care at a GP or emergency. For children over 12 months with a fever who are otherwise alert and coping well, home management and a GP visit if not improving within 2–3 days is usually appropriate.
What is the glass test for rashes? The glass test helps identify a potentially dangerous non-blanching rash — a sign of meningococcal disease or septicaemia. Press a clear glass firmly against the rash. If the rash fades under pressure, it is likely blanching and less urgent. If the rash does not fade, it is non-blanching and requires emergency care immediately.
Can I give my child ibuprofen for a fever? Yes — ibuprofen (e.g. Nurofen for Children) is safe and effective for fever and pain in children over 3 months, given at the correct dose for their weight. Paracetamol (e.g. Panadol Children’s) is also safe from birth. Do not give aspirin to children. Do not give adult formulations of these medications to children. Always follow dosing instructions based on weight.
How do I know if my child is dehydrated? Signs of dehydration in children include: no wet nappies or no urination for 8+ hours, dry mouth and lips, no tears when crying, sunken eyes or sunken fontanelle (soft spot in babies), extreme lethargy or drowsiness, and skin that stays “tented” when gently pinched. Mild dehydration can be managed with oral rehydration solution at home. Signs of severe dehydration (very lethargic, no urine output, unable to keep any fluids down) require emergency assessment.
My child’s emergency visit was triaged as Category 4 — does that mean they’re not being taken seriously? Triage categories reflect urgency relative to other patients, not the significance of your concern. A Category 4 triage means your child needs to be seen but is not in immediate danger. If your child’s condition changes while you’re waiting, return to the triage nurse immediately.
