Parents and carers often face split?second decisions when a child breaks a bone, struggles to breathe or voices frightening thoughts that life is not worth living. An explainer published by Medical Xpress sets out how emergency medical services respond to children and what families can do before help arrives. Paediatric emergencies look different from adult emergencies, and early action can save a child’s life. This report outlines how to recognise a crisis, when to call 999, when to use NHS 111, what paramedics do at the scene, and how to support a child through physical and mental health emergencies. It also covers practical steps that reduce risk, from keeping an adrenaline auto?injector to learning basic first aid. Clear information helps families act with confidence when every minute counts.
Medical Xpress published the explainer online on Monday, 24 November 2025. The guidance below reflects widely used UK practice, including the use of 999 for life?threatening emergencies and NHS 111 for urgent medical advice.
Recognising a true emergency in a child
You should treat any breathing problem, severe bleeding, unresponsiveness or a fit that lasts several minutes as an emergency. Signs that a child needs immediate help include fast or difficult breathing, blue lips, severe chest pain, a weak or absent response when you speak to them, or a rash that does not fade under a glass. A serious head injury, a suspected broken bone with deformity, or heavy bleeding that you cannot stop also needs urgent care. If you have any doubt, call 999.
Children often show illness differently from adults. They can go downhill faster, and they may not explain their pain or symptoms clearly. Trust your instincts if something feels seriously wrong. Look for changes in skin colour, unusual sleepiness, a bulging or sunken soft spot in infants, poor feeding, or a high?pitched cry. For mental health, take any talk of self?harm or suicide seriously, even if it seems sudden or out of character.
When to call 999 and when to use NHS 111
Call 999 for life?threatening emergencies. That includes severe breathing problems, a suspected severe allergic reaction, severe bleeding, a seizure that lasts more than a few minutes, an unresponsive child, or a serious head injury. Call 999 if you think a child has meningitis or sepsis, or if a child has taken a dangerous amount of medication, alcohol or drugs. If a child is in immediate danger of harming themselves, call 999.
Use NHS 111 when you need urgent advice but the situation is not life?threatening. Trained staff will assess symptoms and direct you to care, such as an urgent treatment centre, an out?of?hours GP, or a paediatric emergency department if needed. Many areas also offer 24/7 urgent mental health helplines through the NHS; you can find local numbers on the NHS website. If you have a care plan for a long?term condition, follow it and share it with call handlers.
Breathing problems, asthma and allergic reactions
Breathing difficulties in children need quick action. In asthma, worsening wheeze, breathlessness, a child who cannot speak in full sentences, or little relief from reliever inhalers signal danger. For a known asthmatic child with an action plan, follow the plan. If symptoms do not improve rapidly or the child struggles to breathe, call 999. Keep the child sitting upright and calm. If you have a spacer and reliever inhaler, use them as advised in the plan.
A severe allergic reaction (anaphylaxis) can start with hives, swelling, vomiting or dizziness and progress to breathing problems and collapse. Use an adrenaline auto?injector at the first sign of a severe reaction if prescribed. Call 999 after using it. Lay the child flat with legs raised unless they have breathing trouble, in which case let them sit up. Avoid food or drink. If symptoms continue and a second auto?injector is available, follow the device instructions and clinical advice.
Injuries, fractures and head knocks
Children often fall and injure themselves, but some injuries need emergency care. If a limb looks deformed, swollen and very painful, or if the child cannot use it, support it in a comfortable position and call for medical advice. For heavy bleeding, apply firm pressure with a clean cloth or dressing. If you suspect a neck or back injury, try to keep the child still and call 999.
Head injuries deserve careful attention. Seek urgent care if a child loses consciousness, vomits repeatedly, has a severe or worsening headache, shows confusion, develops weakness, or you notice fluid or blood from the ear or nose. A baby who seems unusually drowsy or irritable after a head knock also needs assessment. Keep the child calm and still. Do not give strong painkillers unless advised by a clinician, and do not let a child return to sport the same day after a head injury.
Seizures, fever and serious illness signs
A seizure that lasts more than a few minutes, or a first seizure, needs urgent help. Protect the child from injury by moving objects away, cushion the head, and note the start time. Do not put anything in the mouth. When the seizure stops, place the child on their side to help them breathe. If you have prescribed rescue medicines for seizures, follow the care plan and call 999 if the seizure continues or you have concerns.
Fever is common, but certain signs suggest a serious illness such as sepsis or meningitis. Watch for mottled or pale skin, a rash that does not fade under a glass, fast breathing, a child who is hard to wake, or a stiff neck and dislike of bright lights. Babies under three months with a high temperature need prompt assessment. Trust your judgement; if you feel your child is seriously unwell, seek help.
Mental health crises in children and teens
A mental health emergency needs the same urgency as a physical one. If a child talks about suicide, self?harm, or harming others, or if they have a plan or access to means, act now. Stay with the child, remove items that could cause harm, and speak calmly. Call 999 if there is immediate danger. For urgent support when there is no immediate threat to life, contact NHS urgent mental health services through 111 or local helplines listed on the NHS website.
Parents can reduce risk by keeping medicines and sharp objects secure, limiting access to alcohol, and knowing how to contact school or community mental health teams. Encourage open conversations about feelings. If a child already receives mental health care, follow the crisis plan and share it with call handlers or responders.
What to expect from paramedics at your door
Paramedics assess airway, breathing and circulation as soon as they arrive. They check vital signs, ask about symptoms and allergies, and examine the child. They use child?specific tools and weight?based calculations to give the right treatments and doses. They can support breathing, control bleeding, manage pain, and treat seizures or allergic reactions on scene.
The team decides whether to take the child to a paediatric emergency department or manage them at home with a clear safety plan. They consider the child’s condition, distance to hospital, and local pathways. They also consider safeguarding and will act if they have concerns about a child’s safety. You should share any care plans, medication lists, and recent medical letters to speed up safe decisions.
What to do while you wait for help
After you call 999, the call handler will guide you. Put your phone on speaker so you can follow instructions. Keep the child warm, calm and still unless they need to sit up to breathe more easily. Unlock the door and move pets away. Gather medicines, allergies, and the child’s NHS number if available. If you can, note times: when symptoms started, when medicines were given, and any changes.
Do not give food or drink to a seriously unwell child unless advised. For choking or cardiac arrest, follow first aid guidance from the call handler. If the child becomes unresponsive and is not breathing normally, start CPR as advised in paediatric first aid training and by the call handler. Any attempt at life support helps until responders arrive.
Preparing your family for emergencies
Preparation makes a difference. Learn paediatric first aid from a recognised provider. Save key numbers: 999, NHS 111, your GP, local urgent mental health helpline. Keep reliever inhalers, adrenaline auto?injectors and other prescribed rescue medicines in date and easy to find. Store a basic first aid kit at home and in the car. Share action plans for asthma, allergies, epilepsy or other conditions with school and carers.
Talk with children about emergencies in a calm, age?appropriate way. Explain that calling 999 brings trained help. Show them how to unlock a phone and give an address. Keep a visible list of medications and key contacts. These steps reduce panic and support faster, safer care.
The Medical Xpress explainer highlights a simple