There are a few tests that you may not have seen in your pediatrician's office that are more common in the emergency department. For example, in the ER, we often check the child's rectal temperature rather than just an oral or a tympanic (ear drum) temperature. This is because the rectal temperature is more accurate and helps guide diagnosis and treatment. In a constipated child, the rectal stimulation (with a thermometer or little finger) may also help stimulate a bowel movement.

A physician may also request a catheterized urine sample. This is collected from the urethra with a tiny plastic tube. This allows the lab to evaluate a clean, uncontaminated sample to check for infection. Urinary infections are a very common cause of fever, fussiness and vomiting in babies and toddlers.

Your child may need to get fluids through an intravenous line, especially if he is very dehydrated or not taking oral fluids. Once the child is better hydrated, you may notice a remarkable difference in how well he looks – children often perk up once they are better hydrated.

Most kids can be gently hydrated by mouth, with juice, oral rehydration solution such as Pedialyte, breast milk or formula. During this period, the physician may opt to observe the child, to see how she feeds, whether she keeps the fluids down and how well she looks after she is better hydrated. Doctors may also observe a child after giving breathing (nebulizer) treatments or after giving certain medications. This period of observation may last a couple of hours and gives the doctor a better sense if your child is really ready to go home (and won't get worse when you get there).

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