Health care providers need to know certain information before parents bring them their sick kids. It's tough to get the story straight when a sick child bounces from day care, to Dad's, to Mom's, to grandmother's house. But to get your child the best health care, accurate details are vital.

"Try to get down to the nitty-gritty," said Dr. Andrew Matthews, medical director of the Emergency Care Center at NorthEast Medical Center in Concord, N.C. Objective observations give health care providers a better sense of what's going on, Matthews said.

Know specifics: How does my child look? Don't just feel his forehead. What's his actual temperature, taken rectally if he is under age 3. Can he open his eyes? How's his breathing? Is he sweaty? Are his lips moist? NorthEast Medical Center has a program called "Ask First." Before calling a doctor, "List all signs and symptoms of an illness. Know medical history, including allergies. List all medications taken, including how much and how often." The information is a starting point, not a diagnosis. "We will always err on the side of caution," Matthews said.

Dr. Greg Guerriero, a pediatrician in Concord, N.C., and father of young twins, says when a parent or caregiver calls into his practice, "We love to know specific symptoms and their duration. There's a lot of difference between 12 hours and 12 days.

"For children older than age 1, before you call the doctor, get a story in your mind about the illness: 'It all started with a runny nose four days ago, then turned into a cough, now my child can't sleep and is running a fever of 102.' "

What he would like for moms and dads to know: Say your child is a toddler or older, has cold symptoms but keeps on playing, and has a fever that responds to Tylenol. "You're not a bad parent if you watch the child for 48 to 72 hours before taking him to the doctor," Guerriero said. "It gets in the way of life, of work, but sometimes an illness just has to run its course."

Answers to the question, "How does my child look?" can be more important than the height of a fever, said Dr. Martin Belson, a pediatric emergency physician for Children's HealthCare of Atlanta and toxicologist for the Centers for Disease Control and Prevention. An exception about fevers, he says: If your child is three months or younger and has a rectal temperature of 100.4 degrees Fahrenheit or higher, don't watch and wait. Call your baby's doctor or play it safe and go to the emergency room. Even a slight fever can be a sign of a potentially serious infection in infants.

Belson agrees that parents and caregivers need to be able to recognize and convey symptoms over the phone. Toward the goals of "prevention and recognition," he created an extensive new Web site: www.kidemergencies.com. Just the topic of fevers -- among more than 50 on the Web site -- has many nuances beyond the "with-babies-don't-wait" guideline. A fever alone may not need to be treated. But consult your physician if the fever is accompanied by any one of these symptoms, to name a few from a list on www.kidemergencies.com: ear pain; sore throat; severe coughing; difficulty breathing; or a stiff neck.

"We're all learning as parents," said Belson, father of two girls, 3 and 6. "It's important for parents to have a physician or nurse to contact over the phone to get information to decide whether to observe the child at home, bring him into the office or take him to the emergency room."

"A lot of people bring their child to the ER with mild symptoms that are just starting to occur," Belson said. "A lot of minor illnesses are viral and just need a little time to run their course." There are "few absolutes" in health care, he says, but he has seen unwarranted emergency room visits, particularly when a primary-care physician is bypassed and the ER is used for routine care.

When a parent knows or suspects a poisoning, it's better to call the Poison Control Center first instead of going straight to the emergency room, he says. The number is (800) 222-1222.

Can you help?

Q. "We have a granddaughter with high-functioning autism. Sometimes people will bend over, get right into her face and speak to her with a high-pitched babyish voice. She can get angry and hit them. How can we tell well-intentioned strangers to back off?"

-- Grandparents in Carrboro, N.C.

If you have tips or a question, please call our toll-free hotline any time at (800) 827-1092 or e-mail us at p2ptips@att.net. Betsy Flagler, a journalist based in Davidson, N.C., teaches preschool and is the mother of a teenage son.