Flu or Flu-like illness in chronically ill or disabled children

Deciding when to get medical help

When children with a long term medical condition or disability have flu or flu-like illness they can develop complications and deteriorate quickly. Hospital treatment may be needed. The parents we spoke to told us why they decided to take their child to see a doctor rather than continue to manage their care at home.
Some parents spoke to their GP or child’s specialist medical team for advice at the first sign of flu or flu-like illness symptoms. Ruth’s daughter frequently went to hospital when she was very young, but now her parents manage any flu-like illnesses at home by staying in telephone contact with their GP. Ruth says keeping in contact with their GP is “a bit of a back-up for us.”
Often parents would contact a doctor if their child’s temperature was not going down despite giving several doses of paracetamol or ibuprofen. Ella’s parents usually give her two or three doses of Calpol (paracetamol) before contacting her specialist medical team. Fiona’s seventeen month old daughter has interstitial lung disease. If her temperature does not go down after two lots of medication, then she phones the hospital ward where she has open door access. Michelle says she would go to the hospital if Jack’s temperature reached 40 degrees.

Other parents sought help when specific things happened, for instance if their child stopped drinking fluids, or if a cough was not improving. Parents of children with asthma had learnt from their asthma medical team when to increase their child’s inhaler and how to manage with medicines at home. Parents found it very stressful watching their child struggling to breathe and would contact a doctor if this persisted despite using asthma medicines. Parents of children with Type 1 diabetes said they needed to get the child to hospital when their ketones were dangerously high. Otherwise they tried to manage at home. Some parents, like Lyndey,Michelle and Jo, said that they just knew their child needed to be seen by a doctor.
Sarah and Susan both have children with Down’s syndrome. They said they would normally go to the doctors after forty eight hours of managing the child’s symptoms at home.
Making a judgement about whether their child’s symptoms were serious enough to be seen by a doctor became easier when parents had more experience of flu-like illness in their child. As the child got older they might also be able to explain how they were feeling. Also ‘knowing’ their child gave parents the confidence to make a decision. During El’s first flu-like illness, Clare waited a week until seeing a doctor because she was worried about taking a child in with flu-like illness to her GP surgery. Now she says if El has flu or flu-like illness again she would go to the GP sooner. During one episode of flu-like illness, Mirella tried to manage at home for quite a long time because she didn’t want to “go [to hospital] too often to cause a fuss”. But now she would go sooner. Mirella said that, “over the years you kind of develop a gut feeling” about when to go to hospital. 

Before Waj’s daughter was diagnosed with cerebral palsy she was getting lots of flu or flu-like illnesses and she was taking her to the doctor all the time until it was explained to her that her daughter’s immune system is weaker. Now when she starts coughing, Waj gets prepared to manage her daughter’s illness at home for as long as she can.

(See ‘Managing flu or flu-like illness at home’.)

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