24/7 Parent-Guided Video Exam & Emergency Triage · Texas & Louisiana
Pediatric Nighttime Fever, RSV, Croup & Earache Video Triage
When your child wakes up at 2:00 AM with a fever, a barking cough, or an earache, our emergency physicians and nurse practitioners examine your child by live video across Texas and Louisiana. With a parent holding the phone camera, we count breaths per minute and check for rib retractions and hydration signs. You get a clear nighttime care plan and an honest answer on whether your child can rest at home or needs a hospital ER right now.
Shared TX & LA 24/7 Solv Queue: One booking link serves all 254 Texas counties and all 64 Louisiana parishes.
Symptoms & Presentations Evaluated on Video
- Childhood fever in toddlers and older kids (note: any infant under 90 days old with a rectal temperature of 100.4°F / 38.0°C or higher needs an immediate in-person ER visit)
- Nighttime barking croup cough or hoarse voice after a head cold
- RSV breathing check: counting breathing speed and checking rib retractions on camera
- Earache or ear tugging in toddlers, plus swimmer’s ear after pool time
- Childhood viral rashes including hand-foot-and-mouth spots and roseola
- Pediatric stomach bug with vomiting and parent questions about wet-diaper counts
How Our Clinicians Evaluate & Manage Your Care
With a parent or guardian on video, our Texas or Louisiana clinician reviews your child’s weight, temperature log, fluid intake, and camera exam. We give you exact weight-based comfort dosing, nasal suctioning and oral hydration steps, a school or daycare note when needed, and a written checklist of overnight warning signs.
The 4-Point Pediatric Camera Exam We Walk Parents Through Live
Grounded in pediatric emergency medicine triage guidelines (Pediatric Emergencies: Fever Without a Source and RSV Bronchiolitis Assessment), you do not need medical tools at home. Your clinician guides you step by step:
The Pediatric Assessment Triangle (Alertness & Comfort)
First, we watch how your child acts in your arms at home: eye contact, cry strength, muscle tone, and whether they perk up once the fever drops.
Shirt-Lifted Breathing & Rib Retraction Check
We ask you to lift your child’s shirt under room light for 30 seconds. We count exact breaths per minute and look for skin pulling in below the ribs, between the ribs, or at the base of the neck.
Capillary Refill & Wet-Diaper Hydration Check
We check mouth moisture, tears when crying, and wet diapers over the past 8 hours. Then we have you press gently on a fingertip or kneecap to confirm pink color returns in under 2 seconds.
Outer Ear, Throat & Skin Check With Your Phone Light
Using your phone’s rear camera and flashlight, we inspect skin rashes (including a clear glass blanching check), outer ear tenderness, and the throat in older kids.
Pediatric Nighttime Triage: Safe Home Video Care vs. Immediate Hospital ER
Here is how our emergency clinicians separate home-manageable childhood illnesses from hospital emergencies:
| Clinical Presentation | What We Check on Live Video | Care Plan vs. In-Person Escalation |
|---|---|---|
| Fever Without a Source by Age Group | Infant <90 days with rectal temp ≥100.4°F (38.0°C) vs. child >6 months who drinks fluids and plays when fever comes down | Infants <90 days with ≥100.4°F always go straight to a physical ER; older playful, hydrated kids receive weight-based home comfort guidance |
| RSV & Viral Wheezing vs. Common Cold | Calm breathing (<40/min in toddlers) and flat ribs vs. rib retractions or breathing >50 to 60/min | Calm breathing is cared for at home with nasal saline suctioning; any rib retractions or grunting routes straight to an ER |
| Nighttime Croup (Barking Seal Cough) | Barking cough only when coughing vs. high-pitched stridor heard while the child sits quietly at rest | Mild croup without resting stridor is managed on video with cool-mist comfort steps; resting stridor or drooling requires an ER |
| Childhood Earache (Middle Ear vs. Swimmer’s Ear) | Pain when wiggling the outer ear or post-cold earache vs. tender red swelling on the bone behind the ear (mastoid) | Uncomplicated ear pain gets targeted comfort care and local follow-up; mastoid swelling routes to an ER |
When to Seek Immediate In-Person Emergency Care
Go to the nearest emergency room or call 911 right away if your baby is under 90 days old with a temperature of 100.4°F (38.0°C) or higher. Also go immediately if a child of any age has rib retractions when breathing, noisy stridor while resting quietly, blue lips, extreme drowsiness, a stiff neck, a purple rash that does not fade under a glass, or zero wet diapers for over 8 hours.
Real Texas & Louisiana Telemedicine Scenarios
2:30 AM Barking Cough in a Three-Year-Old
Situation: A toddler in Collin County wakes up with a sudden barking cough after two days of a runny nose. His parents want to know if they need a children’s ER tonight.
Video Evaluation: Our clinician listens to the child breathing quietly on camera (confirming zero resting stridor) and watches his bare chest wall (confirming zero rib retractions).
Outcome: The parents get calm reassurance, nighttime cool-air comfort steps, and exact red flags that would require an ER trip.
Sunday Ear Pain After Swimming on the Northshore
Situation: An eight-year-old in St. Tammany Parish gets throbbing right ear pain after a weekend in the pool.
Video Evaluation: Our Louisiana clinician checks the outer ear on HD video, confirms there is no bone swelling behind the ear, and separates swimmer’s ear from deeper complications.
Outcome: The family receives a targeted ear care plan and a Monday school note without waiting in a clinic lobby.
Toddler With Stomach Bug & Hydration Check
Situation: A two-year-old throws up three times in four hours and her parents worry about dehydration.
Video Evaluation: Our clinician checks capillary refill and alertness on camera, then teaches the parents the 5-milliliter oral rehydration pacing method.
Outcome: The child keeps small frequent sips down at home with a clear 6-hour hydration check plan.
Verified Clinical Team · Statewide 24/7 Texas & Louisiana Telemedicine
Meet the Physicians & Nurse Practitioners Behind Your Care
Every video visit is conducted by our licensed emergency physicians, family medicine physicians, physician assistants, and emergency nurse practitioners. Our clinicians provide hospital-grade 24/7 telemedicine anywhere in Texas and Louisiana.
Emergency-Trained Clinical Depth, Delivered Statewide From Home
Unlike generic telehealth call centers, Virtual ERs is staffed by practicing emergency medicine clinicians who evaluate acute symptoms over live HD video, coordinate same-day care plans in your neighborhood, and guide in-person diagnostic or emergency escalation whenever needed.
Meet all 15 physicians & nurse practitioners on our team →
Common Questions
Can I use Virtual ERs telemedicine for my child late at night in Texas or Louisiana?
Yes. Our clinicians evaluate children 24/7 across Texas and Louisiana whenever a parent or legal guardian joins the live video visit with the child.
Why must babies under 3 months old with a fever go to an in-person ER?
In babies under 90 days old, a rectal temperature of 100.4°F (38.0°C) or higher can be the only early sign of a serious infection. Pediatric emergency guidelines require an immediate in-person hospital exam and lab tests.
How can a clinician tell on video if my child’s breathing is safe during RSV season?
In young kids, hard breathing shows up on the chest wall before oxygen numbers drop. By watching your child’s bare chest on camera for 30 to 60 seconds, our clinician counts exact breaths per minute and checks for rib retractions and nostril flaring.
What should I have ready before starting a pediatric video visit?
Have your child’s recent weight in pounds, a temperature reading, good room light, and a second phone light to help show the skin or throat.
Ready to Start Your 24/7 Video Evaluation?
Connect from anywhere in Texas or Louisiana with no app download and no waiting room.