My specialty is certainly not pediatric or labor and delivery ....but as an RN any fever that can't be treated or stabilized at home with rotation of Children's Motrin and Children's Tylenol is certainly a need for a MD visit. Any fever of 103 is alarming. Children crash quick--especially asthmatic children. Nobody should ever smoke around children who have asthma. Not even in the car--or hold children in their arms if they are a smoker. I hate seeing children come in sick with parents who smell like a cigarette factory and they say "I only smoke outside". BIG DEAL if you are carrying your child on your shoulder.
There are many factors in triage-regardless if it is a fever or not. Most suffering children (emergent) are what we call lethargic or sickly. Sleepy-not crying as much, not as many wet diapers in a day, dry lips, flushed face/ears....Temp of 101 can certainly be pneumonia or teething. You have to look at the child and put the story together--if something isn't adding up--it is possible critical and that child would not wait 11 hours in any ER.
Dehydration sets in quick with elder population as well. Vomiting 12 times in 2 weeks is not dehydration. Vomiting 12 times in one day is alarming.
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