Child has a high fever: on-call room, ER (UPU) or pediatrician?

This article helps you know WHERE to go and what your rights are — it does not offer medical advice. It contains no diagnostic criteria and does not recommend treatments or medicines. For a real emergency, call 112.

In short: during opening hours you go to the medic de familie (family doctor) or the pediatrician; outside opening hours or when the situation is serious, to the pediatric on-call room / ER (UPU); and if signs of a major emergency appear, you call 112 immediately. Fever in a child is common and most of the time resolves through the usual channels — what matters is knowing which door to open and when.

During opening hours: the family doctor or the pediatrician

The first line for a child with a fever, during the day and on working days, is the medic de familie (family doctor) or the pediatrician. They know the child’s history, can assess the situation, and decide whether investigations or a referral onward are needed.

• Call the practice first to find out the opening hours and whether they can see you that day.
• Do you need a pediatrician? See the list of pediatricians in Cluj and the practices on the map.
• For a consultation covered by CAS with the family doctor you need insured status; with a pediatrician in the private system, the consultation is paid.

The family doctor also remains your point of reference for continuing care after a visit to the Emergency room.

Outside opening hours or in serious situations: the on-call room / ER (UPU)

When the practice is closed — in the evening, at night, on weekends or holidays — or when the child’s condition seriously worries you, go to:

• the pediatric on-call room of a hospital, or
• the UPU / CPU (Emergency Reception Unit/Department) with a pediatric profile.

In Cluj-Napoca, pediatric emergencies are handled mainly by the Cluj-Napoca Emergency Clinical Hospital for Children. Always check which hospital is on call that day, because the on-call duty may be organized across different units.

What is important to know about the Emergency room:

• You do not need a referral (bilet de trimitere).
• You cannot be turned away for not having your health card or for not being insured.
• You do not pay — emergency care in the ER (UPU) is free.

Signs of a major emergency: call 112 immediately

There are situations in which you do not drive the child yourself and you do not wait — you call for emergency help. Call 112 immediately if a child:

• is breathing with difficulty or has obvious breathing difficulties;
• has convulsions (seizures);
• is hard to wake, limp, or unresponsive.

These are not diagnostic criteria to tick off, but warning signals to which the correct response is a single thing: 112. The dispatcher guides you and sends the ambulance or SMURD (the mobile emergency service). The emergency service via 112 is free.

What to take with you to the on-call room or ER (UPU)

So you don’t lose time at reception, have at hand:

• the child’s identity document (birth certificate) and yours;
• the health card, if you have it (not mandatory at emergencies, but it helps);
• the relevant medical documents — medical letters, recent test results, previous discharge notes;
• the list of medicines the child takes, if applicable, and any known allergies.

Don’t worry if you are missing some documents: at the emergency room the child is seen anyway. The documents only make the doctor’s work easier.

Your rights at the Emergency room

The law guarantees you a few things that matter when you are scared and in a hurry:

• The right to triage and to be seen. Triage sets the order based on severity — critical cases go first, so you sometimes wait if your child’s condition is not critical. It does not mean you are being turned away.
• The right to free emergency care, whether or not you are insured.
• The right to information — to have explained to you what is happening with the child, in terms you understand (Law no. 46/2003 on patient rights).
• The right not to be discriminated against in access to emergency care.

If you feel something is wrong, you can ask to speak with the on-call doctor and can later report it to the hospital management.

How to quickly choose the right door

Without making diagnoses, the practical question is “where”:

• Is it daytime, the practice is open, the child is stable? → the medic de familie (family doctor) / the pediatrician.
• Is it evening/night/weekend, or are you seriously worried? → the pediatric on-call room / ER (UPU).
• Is the child breathing with difficulty, having convulsions, unresponsive? → 112, immediately.

After the visit to the Emergency room

After the child has been seen at the on-call room or ER (UPU), continue the care with the medic de familie (family doctor) or the pediatrician, who takes over the recommendations and follows the progress. Keep the documents you received (discharge note, results) — they are useful at the next check-up.

If you don’t yet have a regular pediatrician, this is a good moment to choose one: search in the directory of pediatricians, check the doctors in Cluj-Napoca, and call the practice for the opening hours.

Sources

• Law no. 46/2003 on patient rights (the right to information, to care, to non-discrimination).
• Law no. 95/2006 on health reform — emergency medical care and the principle of free care in the UPU/CPU.
• The 112 / SMURD emergency service — free call for medical emergencies.
• For the on-call hospital of the day, check the notices from the Cluj-Napoca Emergency Clinical Hospital for Children and the Cluj Public Health Directorate.