Picture some common scenarios:

  • In the middle of the night, your toddler wakes with a fever and says that his ear hurts.
  • On a Saturday afternoon, your daughter hurts her ankle at a soccer game.

Inevitably, kids get sick or injured at times when the doctor's office is closed. How do you decide whether to go to urgent care versus the emergency room?

Note: If you think your child may be experiencing a life-threatening or other severe condition, you should call 911 immediately or go directly to the nearest emergency department.

Some situations aren't clear-cut, and what constitutes an emergency in a child can be different from the same situation in an adult. (See our article on emergency vs. urgent care for adults.) Here are some tips to help you figure out where to take your child for treatment.

When to go to the emergency room

Emergency departments are designed to treat life-threatening issues that need immediate attention. They also handle complicated or serious injuries, such as broken bones and severe burns, that may require a specialist's attention. Our pediatric emergency departments are staffed with doctors and nurses trained in pediatric emergency medicine, so they have expertise on treating illness and injury in the young. Patients have access to advanced testing and imaging resources, such as ultrasound, MRI and CT machines, as well as more than 150 pediatric specialists. The San Francisco and Oakland pediatric emergency departments are open 24 hours a day, every day.

The following is not a complete list, but symptoms or situations that may warrant a trip to the emergency room include:

  • A fever of 100.4 F (38 C) or higher in a baby under 2 months old
  • A head injury and loss of consciousness (even if this lasts only a few seconds)
  • A seizure
  • A broken bone in which the area or limb looks bent or deformed or the bone is protruding
  • Dehydration (some possible signs: dry lips and mouth, lethargy, confusion, very little or no urination for more than 12 hours)
  • Difficulty breathing; hard, fast breathing; or (in children who have developed language) the inability to speak more than two or three words
  • A deep or gaping cut
  • A severe asthma attack
  • Bleeding that won't stop
  • A severe burn
  • Ingestion of something known to be toxic or possibly toxic
  • A swallowed object
  • Severe headache
  • Fainting

Emergency room options

UCSF Pediatric Emergency Departments (San Francisco, Oakland)

When to go to urgent care

If your child has a problem that isn't life-threatening but shouldn't wait until the following day, urgent care is the right choice. These clinics work like an extension of your pediatrician's office, providing after-hours treatment for most common childhood ailments. Reasons for a trip to urgent care include but aren't limited to:

  • Congestion or cough
  • Ear pain or drainage
  • Wheezing without being breathless
  • An allergic reaction that doesn't involve trouble breathing
  • A sore throat
  • A simple fracture (in which the bone isn't bent or protruding)
  • A minor cut or burn that needs professional cleaning and dressing
  • Conjunctivitis (pink eye)
  • Stomachache
  • Vomiting and/or diarrhea without blood in the stool, belly pain or signs of dehydration
  • A worrisome insect bite, especially If from a spider or causing a serious reaction
  • A sprained or strained muscle
  • A possible urinary tract infection (some signs: irritability, fever, frequent urination, pain while urinating)
  • Dizziness

Urgent care options

UCSF Pediatric Urgent Care (San Francisco, Oakland, Larkspur)

GoHealth Urgent Care Mill Valley

The following urgent care clinics also see children over the age of six months, though there is not a pediatrician on site:

Go Health Urgent Care (San Francisco, Oakland, Daly City, San Bruno, and Redwood City)

Golden Gate Urgent Care (San Francisco, Oakland, and Mill Valley)

Berkeley Outpatient Center (Berkeley)

Circle Medical (San Francisco)

One Medical (35 Bay Area locations)