Paediatric experience – not every doctor is a paediatrician
Children are not small adults. Their anatomy, physiology and disease dynamics differ fundamentally. For house calls to children, RAB sends physicians with solid paediatric experience – either through paediatric clinical work, dedicated emergency paediatric training, or many years of general practice with family patients.
This distinction matters. A bronchitis that looks harmless in an adult may be RSV bronchiolitis with a threatening course in a toddler. An apparent gastroenteritis may be intussusception. Paediatric competence is non-negotiable.
We treat children from three months of age on house calls. Infants under three months are a clinical risk category with a low threshold for inpatient care – we recommend direct presentation at a Berlin paediatric clinic such as DRK Westend, Charité Campus Virchow, Helios Berlin-Buch or Sankt Joseph in Tempelhof.
Typical paediatric reasons for a house call
Fever is by far the most common reason. In children over three months with fever up to 39 degrees and preserved general condition, a house call is an excellent option. We assess general condition, hydration, skin colour, breathing, consciousness and social responsiveness – paediatric basics.
Respiratory infections with cough, runny nose and moderate fever are the daily bread of Berlin family practices. We treat common colds, mild bronchitis, early bronchiolitis in older toddlers and uncomplicated sore throats. A streptococcal rapid test on site clarifies the antibiotic question.
Acute otitis media is diagnosed with otoscopy and treated to AWMF guidelines. Gastrointestinal infections, provided the child is not severely dehydrated, are another regular case. We advise and treat in rashes, conjunctivitis and early childhood illnesses such as hand-foot-mouth or roseola.
What we do during a child's house call
Paediatric examination starts with observation: how does the child behave with the parents present? Is there play interest or apathy? How is breathing? How are skin colour and turgor? This observation is often more meaningful than any single finding.
We then perform age- and complaint-appropriate measures: auscultation of lungs and heart, inspection of throat and ear drums, abdominal palpation, basic neurology, pulse oximetry, temperature measurement, and rapid tests for group A streptococcus, influenza, RSV or urine dipstick where indicated.
Parents are involved throughout. We explain what we do, why we do it and what findings mean. This transparency is part of medical care and reduces parental anxiety in the face of a sick child.
Treatment and parental guidance
Treatment of viral infections is largely symptomatic: adequate fluids, gentle food as tolerated, antipyretics with paracetamol or ibuprofen dosed by weight and age, physical rest. Antibiotics are not indicated in viral disease and cause more harm than good.
For bacterial tonsillitis with positive streptococcal rapid test we prescribe penicillin or amoxicillin according to guideline. In otitis media with fever and reduced general condition antibiotics may be indicated; in mild courses watchful waiting is also an option.
Parents receive clear written guidance: what is normal, what are warning signs, when to call again or attend hospital. We discuss temperature measurement, fluid intake, respiratory rate and behaviour – the key parental observation points.
When the child belongs in hospital
Infants under three months with fever are categorically a paediatric clinic case. In this age group the immune defence is still immature, the course can escalate quickly, and more elaborate diagnostics – including blood cultures and lumbar puncture – may be required.
At any age, warning signs include altered consciousness, seizure, respiratory distress with retractions or nasal flaring, persistent fever above 40 degrees, petechiae (pinpoint skin haemorrhages), neck stiffness, severely reduced intake with low urine output, persistent vomiting with signs of dehydration.
In these situations dial 112 or go straight to a paediatric emergency department. We refer consistently on the phone – triage honesty is part of medical responsibility. In doubt call +49 30 550 77 870; dispatch helps with the assessment.