Urgent Care, Pediatric ER, or Call the Doctor? A Roanoke Parent’s Guide to Where to Go When Your Kid Is Sick

From the Peter Pan Playground in Elmwood Park to Longwood in Salem and the fenced, fully inclusive Addy Grace Playground in Daleville, here's our local guide to the Roanoke Valley's playgrounds and parks, with drive times and what each one is good for.

Words by RoanokeFamily Editors

It's 11 p.m., the thermometer says 102, and you're standing in the hallway doing the math. Wait until morning? Drive to urgent care? Head straight to the emergency room at Roanoke Memorial? Every Roanoke Valley parent has been there. This guide walks through when to call your pediatrician, when urgent care is the right fit, and when a trip to the emergency room can't wait, with the local options for each. It's general information to help you plan ahead, not a substitute for medical advice. When in doubt, call your child's doctor.

Call 911 First for These

Some situations aren't a choice between urgent care and the ER. Call 911 if your child is struggling to breathe, has blue or gray lips, is unresponsive or very hard to wake, has a seizure, has a serious injury such as a head injury with confusion or a deep wound that won't stop bleeding, or shows signs of a severe allergic reaction like swelling of the face or throat.

If you think your child swallowed something harmful, such as medicine, a cleaning product, or a button battery, call Poison Control at 1-800-222-1222. The line is free and staffed around the clock. For a button battery or any trouble breathing, call 911.

Start With Your Pediatrician

For most illnesses, your first call should be your child's own doctor, even after hours. Most Roanoke Valley pediatric practices have an after-hours nurse line or an on-call provider who can tell you whether to wait, come in first thing, or go now. Keep that number saved in your phone and on the fridge for the babysitter.

Call your pediatrician for things like a fever in a child over 3 months old who is otherwise drinking and acting mostly like themselves, ear pain, a sore throat, a rash without other worrying symptoms, mild vomiting or diarrhea, or a cough and cold that's lingering. Your pediatrician knows your child's history, which makes their advice more useful than anyone else's.

One important exception: for a baby younger than 3 months with a fever of 100.4°F or higher, call your pediatrician right away. If you can't reach them, go to the emergency room. Fevers in young infants need prompt evaluation.

If you're still looking for a practice, our guide to finding a pediatrician in the Roanoke Valley covers what to ask and how to choose.

When Urgent Care Makes Sense

Urgent care fills the gap when your pediatrician's office is closed or booked and the problem needs attention soon but isn't an emergency. Good urgent care situations include minor cuts that may need stitches, sprains, a possible simple fracture like a finger or wrist, ear infections, strep throat symptoms, pink eye, mild asthma flares that respond to your child's usual inhaler, and urinary symptoms.

Around the valley, VelocityCare by Carilion has walk-in urgent care locations in Roanoke, Salem, and Daleville. LewisGale has family and urgent care locations in Roanoke, and Express Family Care has locations in Cave Spring and near Bonsack. Retail clinics like CVS MinuteClinic can handle simple issues, such as a sore throat check, for older kids.

A few tips before you go. Call ahead or check online to confirm the clinic sees children and to ask about minimum ages, since some urgent cares don't see babies or toddlers. Many clinics offer online check-in to save your spot, which beats sitting in a waiting room with a miserable kid. Bring your insurance card, a list of your child's medications and allergies, and something to keep them busy.

When to Go to the Emergency Room

Head to the emergency room for problems that could be serious or that urgent care isn't equipped to handle. That includes a fever with a stiff neck, a very sleepy or limp child, or a fever in a baby under 3 months. It also includes trouble breathing that isn't improving, signs of dehydration such as no wet diaper or no urination in many hours, a head injury followed by vomiting or unusual behavior, a possible broken bone that's visibly out of place, a deep or gaping wound, severe belly pain, or a mental health crisis.

The Roanoke Valley has something many regions don't: a dedicated pediatric emergency department. Carilion Children's Hospital, inside Carilion Roanoke Memorial Hospital off Jefferson Street, is the region's only children's hospital and western Virginia's only Pediatric Level 1 trauma center. Its emergency department is devoted to children, with pediatric-trained staff and kid-sized equipment. The expanded emergency department at Roanoke Memorial includes a dedicated pediatric waiting area, triage space, and patient rooms.

LewisGale Medical Center in Salem also has a full emergency room, and hospital ERs across the region can stabilize a child and transfer them to Carilion Children's if specialized care is needed. In a true emergency, go to the closest ER or call 911.

A Quick Way to Decide

If you're not sure, ask yourself two questions. First, could this be life-threatening? If yes, or if you truly can't tell, call 911 or go to the ER. Second, can it safely wait until your pediatrician's office opens? If yes, call the after-hours line for advice and book the first appointment. Everything in between is usually an urgent care visit, and your pediatrician's nurse line can help you confirm that.

The American Academy of Pediatrics' HealthyChildren.org has a symptom checker and plain-language guidance parents can use while waiting for a callback.

Get Ready Before You Need It

The middle of the night is a hard time to look up phone numbers. A little prep now makes the next sick night easier. Save your pediatrician's after-hours number and Poison Control, 1-800-222-1222, in your phone. Pick the urgent care you'd use and confirm it sees kids your children's ages. Keep a current list of each child's medications, allergies, and weight, since doctors dose by weight. And know your route to Roanoke Memorial and to your closest ER, especially if you live out in Botetourt, Franklin, or Bedford County.

For more local health resources, from dentists to therapists, visit our Roanoke Valley family health resources guide.

Quick Answers for Roanoke Parents