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On-Call Guidelines

phone iconWe greatly value your needs and concerns. Sometimes, you need late-night advice when a child is sick and you aren’t sure what to do next. We are always proud to help in any way we can. However, it is important to note the difference between an emergency and something that can wait until morning. Many nights, our providers are overwhelmed with non-urgent calls that make it difficult to care for our patients in need. Please help us to better serve you by making note of the following on-call guidelines.

When to Go to the ER or Urgent Care

  • High fever (Newborns less than 1 month of age over 100.7°F & older kids over 103.5°F if unresponsive to a fever reducer)
  • Difficulty breathing
  • Severe dehydration
  • First-time seizure
  • Significant injury (broken bone, laceration, car accident, etc.)
  • Bleeding that won’t stop
  • Profound lethargy

Emergency rooms everywhere are packed with patients, especially for less severe cases. ER wait times are an average of 4 hours in some hospitals. Parents typically take their kids for respiratory illness and fever, injuries, and vomiting/diarrhea, but some symptoms don’t necessarily require emergent action. It’s important for you to trust your instincts. No one knows your kid quite as well as you do, so trust your ability to discern true illness. However, middle-of-the-night episodes can lead to decisions based on exhaustion and thought-escalation rather than need.

Newborns

Infants up to 12 weeks of age still have an immature immune system and are more fragile than older kids. Almost anything out of the ordinary for newborns can be cause for concern and possible emergency. Don’t medicate them for fever until their pediatric provider has seen them unless already directed you to do so. Medications like acetaminophen and ibuprofen can sometimes mask the severity of fever or symptoms.

Fevers

As a general rule for fevers,

  • take newborns (under 1 month) to the ER for temperatures over 100.7°F
  • take older kids for temperatures over 103.5°F (check first to see if they are responsive to fever reducers, like Tylenol or Motrin)

Fevers are a good thing. If your kid has a fever, it means their immune system is working and fighting off an infection. We recommend giving Acetaminophen (Tylenol) or Ibuprofen (Advil, Motrin) to kids with fevers or headaches. Headaches with or without fever are not considered life-threatening. Only worry if your kid isn’t eating, drinking, playing, or is confused or having difficulty walking. Take your child to the ER if your child develops a seizure.

When to Call 911

  • Your child is unconscious
  • Your child is blue
  • The airway is blocked
  • Your child is badly injured
  • You cannot move your child

On-Call Etiquette

Certain times, we are not available for an emergency question. If it is lunchtime, dinnertime, or overnight, we cannot always respond to you quickly. If you are experiencing an emergency, refer to this page about when to go to the ER and when to call 911. Once you’re already on the way to the ER or are at the ER, just go in. Wait until daytime operating hours to update us on your situation so we can schedule you an appointment for a follow-up and face-to-face discussion.

When to Call Us

If you need immediate advice on an urgent medical problem, please call us. You can also text us at the office number, (562) 473-4441. We can give advice about how to treat a medical problem at home or help to figure out if it’s time for you to go to the ER. You should always trust your instincts as parents. If you think you need to go to the ER or call 911, don’t wait for us to contact you back to do so.

We ask that non-urgent matters wait until regular business hours. When you call, your message goes directly to a provider, not a call center. On-call providers are typically asleep between 10 pm and 6 am. Please take care when you are contacting on-call providers. We need adequate sleep and downtime to be the best we can be during your office visits. Please allow us the same courtesy you would extend to a neighbor or friend and refrain from waking us up for non-urgent concerns.

For questions on specific topics, please refer to our holistic care blog or stop by the office for one of our handouts. We continue to publish information for your benefit. Shoot us an email or check the website for answers to your questions. We look forward to hearing from you!

When to Wait

  • “I need the dose for Tylenol.” Over-the-counter medications have information about dosages for your children on most packaging and on the internet. In addition, we have published and printed many guides to help you with dosages. If you still aren’t sure, please call during regular office hours.
  • “I need a medication refill.” On-call providers don’t have access to your record and we simply cannot refill medications after hours. Please have your pharmacy request a refill or call during the day.
  • “I need to move my prescription to another pharmacy.” Call that pharmacy and ask for a prescription transfer to a different pharmacy. Our pharmacies are our friends. They have a wealth of information and instructions about your medications.
  • “Can my sister’s medication work for my daughter’s medical problem?” No. Never use medication prescribed for anyone else. Schedule an appointment for problems that you think require specific medications.
  • “What are the hours for my urgent care?” Call your local urgent care center. They can help with many of your after-hours needs, in addition to open hours and locations. Our favorites are Memorial Care on Stearns and Bellflower, Medpost Urgent Care in Los Alamitos, and Nair Urgent Care at the Marketplace in Long Beach.
  • “I need to review my child’s immunization record.” This information is only available if we have your child’s chart in front of us. Save that phone call for regular business hours when our staff can pull up your chart. Often you can send us an email, or access that information through your online portal.
  • “I’d like to review my child’s visit from today.” If you are a parent or guardian that was not present during your child’s visit, you will not be able to review your child’s information after hours. The person your child saw may not be the on-call provider, so call during daytime hours to review their information or contact the provider your child saw. You can also access this information through the online portal.
  • “I need to see my lab results.” Typically, the only time you need to call for lab results is when the provider who ordered the labs told you they were critical. In this case, call during daytime hours. Note that lab tests take days and sometimes weeks to come back. You may also review some lab results on the patient portal.
  • “My partner and I don’t agree with how something should be done.” If there is a disagreement that is an emergency, it is always important to call us. However, wait until the morning if you don’t agree on how your child is being cared for at home and your child isn’t in any immediate danger.
  • “I need a referral.” Referrals can be requested during daytime hours. Make requests in writing and drop them off, fax them to (562) 473-4447, or email them to ght@ghtkids.com.
  • “My child has head lice.” If your child has head lice, is constipated and doesn’t have severe pain, or other non-urgent complaints or symptoms, wait until morning. Many non-urgent issues can wait until morning to contact the on-call provider.
  • “Which humidifier should I buy?” Online shopping is not an emergency and can wait until business hours.

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