My 18-month-old daughter has had a fever
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My 18-month-old daughter has had a fever of 103°F since this afternoon. In the last hour, her breathing has gotten noticeably fast and noisy, and when she breathes in, the skin between her ribs and below her ribcage sucks in deeply (retractions). She is lethargic and refusing fluids.
Should we wait until our pediatrician opens tomorrow morning, or go to the nearest emergency room immediately? What should we do right now while heading out?
Answer
I'll check the emergency cards and family profile in parallel.
I'll write the draft, then run the safety check.
Go to the nearest pediatric emergency department now — do not wait until morning.
An 18-month-old with fever plus retractions, fast and noisy breathing, lethargy, and refusing fluids is showing the textbook emergency signs. The skin pulling in between her ribs and below the ribcage on inhale means she is working hard to move air; the drowsiness and refusing fluids alongside that picture is not a "wait and see." Call your local emergency number now — ambulance if it can arrive faster than you can drive, otherwise set off for the nearest pediatric-capable emergency department right away. Tell the dispatcher: "18-month-old, fever, breathing very fast with retractions, lethargic, refusing fluids."
On the way:
- Let her stay in the position she has chosen (often sitting forward on a caregiver's lap). Do not lay her flat.
- Stay with her. Keep handling to a minimum so she does not waste energy.
- Do not force fluids. Small sips only if she asks.
- Do not wipe her down with rubbing alcohol; do not put her in a cold bath.
- Note: when the retractions started, how the breathing sounds, her last wet nappy, when she last drank, and any fever-reducing medicine already given (name only — keep the bottle).
Do not:
- Wait until the pediatrician opens.
- Give a second fever medicine "to alternate" or any leftover antibiotic.
- Use rubbing alcohol or a cold bath to bring the fever down.
- Try to suppress the symptoms with extra medicine to "buy time" — that hides the picture the team needs to see.
To bring or be ready to say on arrival:
- Age 18 months; immunisation status.
- Fever readings with times and how measured (for example rectal 103°F / 39.4°C), and what was given for comfort.
- When the breathing changed, and what was seen (fast rate, retractions, noise, drowsiness, refusing fluids).
- Allergies and current medicines.
Please tell me your country or city so I can name the right local door and follow-up. In the meantime, please do not delay the call.