Is it a Cold or the Flu?

How to tell if your child has a cold or the flu. Should you go to the hospital, call 9-1-1, go to the doctor or do nothing.



Is it a Cold or the Flu? Should I call for help? What should I do?

You are frantically waiting for me to arrive. Three minutes ago you picked up the phone and called 9-1-1 as your five-year-old is not well. When you made the call the call taker asked you a lot of questions. Is he conscious? Is he having trouble breathing? Is he alert? You answer the questions to the best of your ability explaining that your son is sick and has a very high fever. He is really weak and not eating. You are really worried about him.

When I arrive at your home, you meet me at the door and thank me for coming so quickly. As we head to the family room to assess your little one, you tell me that you are sorry to bother me but you didn’t know what to do or who to call. We reassure you that we are not upset and that you are not bothering us and that we are always happy to respond anytime day or night.   

Now that we are in your family room, we are able to assess your son. He is conscious and alert albeit weak and he has a fever. He is laying on the couch watching TV. We examine him and to see if there are any life threatening signs or symptoms. Is he dehydrated? Is he having difficulty breathing? Does he have any rashes or skin abnormalities? We ask you a lot of questions. Is he going to the washroom? Is he drinking? Are his vaccinations up to date? Does he have any medical conditions or take any medications? Has he had Tylenol and/or Advil?

Nothing matters more when it comes to our children. Their health and safety trump everything. Even our own health and safety. So, it is really no surprise that parents call 9-1-1 or rush to the local emergency department when their children have what appears to be the flu or a cold. As a parent I understand the fear that we can get when our children are sick. As a paramedic, I know that the fear is not rational and stems from a lack of good information and knowledge.

What is a cold or flu?

A cold and flu are similar and often very difficult to distinguish as they share common symptoms, such as a sore throat and runny nose followed by fever and weakness. They are both caused by one of over 200 respiratory viruses.1 The big difference is that the symptoms of the flu are more severe and intense often resulting in the development of more serious illnesses such as pneumonia.2 Since both are viruses, antibiotics are not indicated and will not help as antibiotics are for bacterial infections only.3  

Although the cold season is most prevalent in the winter months it is possible to catch a cold or the flu year round. So why the winter months? During the cold winter months, we spend a disproportionate amount of time indoors in close proximity to other people. Since the flu and cold viruses are spread through the air from person to person when people talk, cough or sneeze, it is no surprise that these illnesses spike in the winter.4 Some scientists believe that cold dry winter air encourages the spread of viral droplets that lead to flu and colds. And, our dry noses encourage these viruses to take hold, making us sick. Of course, it is possible to catch a cold or the flu by touching objects that have the flu or cold virus on it.1,2,3,4 Having wet feet or not wearing a jacket or hat has nothing to do with getting sick.

Schools and daycare centres are the perfect breeding ground to get sick as youngsters forget to cover their mouths and noses when they cough and sneeze, and often touch toys and other objects that end up in other children’s mouths.4 Coupled with an immature immune system and wham ... your child is sick. Children usually get 5 – 7 colds a year which is much more than the 2 – 3 adults average 1,2. Of course keeping the little ones home from school or daycare when they are sick limits the spread of the flu and cold virus.

When should I call for help or go to the hospital?

Now that your child is sick, we need to determine if we need to go to the hospital, call 9-1-1, go to the doctor or do nothing. Always call 9-1-1 or go to the hospital if your child is unconscious or difficult to wake up, is having trouble breathing, develops seizures or is dehydrated. Follow up with your physician after a few days if your child is still having a fever or just isn’t getting better. No matter what, if your gut feeling tells you to call for help or go to the doctor, listen to it and get help.

So how can you determine if your child is really having trouble breathing.  Most people, especially children, will complain of trouble breathing when they have a cold. As I write this article, my 6 year old daughter Eryn is sick with a cold and has been complaining of having trouble breathing. Eryn is not actually having any trouble breathing but rather is expressing the discomfort she is feeling from having a stuffed nose with associated postnasal drip causing her sore throat. Double whammy.

Here are the signs to look for to determine if your child is having trouble breathing:

• Look at their nose and mouth. Is the nose flaring or are their lips pursed out when they breath?
• Look at the neck and ask if they are using their neck muscles when they breath?
• Look at their chest and ask if they are using their chest muscles when they breath?

If you see any of these signs, then your child is having trouble breathing and a call to 9-1-1 or visit to the hospital is appropriate and encouraged. Here is a great video of what trouble breathing in a child looks like. Take a first aid and CPR course to be better prepared.

Ok, I’m keeping my kids home from school. What can I do to help them?

Rest assured that they will get better in 5 to 7 days. They need lots of rest and should drink lots of fluids.3,4 You can use a clean humidifier, cool mist vaporizer or saline nasal drops to help with the stuffed nose and sore throat.4 Of course Tylenol and/or Advil are great at relieving fever and pain associated with colds and the Flu. Tylenol works quickly at reducing fever and pain but doesn’t last long which is why it can be given every four hours. Advil takes longer to work but works better over a longer period of time which why it is given every 6 – 8 hours. Tylenol and Advil can be taken together as they are completely different medications. I recommend you consult with your pharmacist to discuss symptom relief and dosing for your children.

Until next time stay healthy, drink lots of fluids, get lots of rest, wash your hands and practice proper cough and sneeze etiquette which is to cough or sneeze into your arm, not your hands.

References:
1. Centers for Disease Control and Prevention. (2015, 08 07). Key Facts about Influenza (Flu) & Flu Vaccine. Retrieved 02 29, 2016, from Influenza (Flu): www.cdc.gov/flu/keyfacts.htm
2. Centres for Disease Conrtol and Prevention. (2015, 04 17). Common Cold and Runny Nose . Retrieved 02 29, 2016, from CDC : www.cdc.gov/getsmart/community/for-patients/common-illnesses/colds.html
3. Schmidt, S. (2015, Autum). Ready, steady, winter: what the pharmacist’s assistant should know about vaccination, colds and flu. SA Pharmacist's Assistant.
4. WebMD. (2015, 03 02). Cold, Flu, & Cough Health Center. Retrieved 02 29, 2016, from WebMD: www.webmd.com/cold-and-flu/cold-guide/understanding-common-cold-basics?page=2

About the Author: Robbie Ichelson is the Chief Learning Officer and Director of canaPHEM which provides authentic prehospital education including first aid and CPR to families, workplaces, and organizations throughout the GTA. He practiced paramedicine as an advanced care paramedic for over 20 years in urban, suburban and rural Ontario. During his time as a paramedic he has educated and mentored many paramedics through all phases of their initial and ongoing education. Robbie is also a researcher focusing on prehospital sepsis identification and management by paramedics. He lives in Whitby with his wife and four children ranging in age from 4 – 16. You can contact Robbie at info@canaphem.ca or by visiting his companies website www.canaphem.ca.

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