Doctor for a sick child at home in Berlin — when does it make sense?

When a house call for a child is the right choice

Setting a sick child into the waiting room of a crowded on-call practice is an experience no-one wants — neither the child sitting tired and aching on a wooden bench nor the others who would rather not be infected on top. A private house call brings care to the familiar environment: the child stays in its own bed, with parents, without the stress of car ride, queue and unfamiliar faces. We examine throat, ears, lungs, abdomen, lymph nodes and skin, run — if indicated — an influenza, RSV or strep rapid test and discuss therapy and especially the red flags for escalation.

The paediatric house call is sensible for classical respiratory infections with fever, otitis media, gastroenteritis without strong dehydration, rashes, suspected strep tonsillitis, suspected toddler UTI and many other routine pictures. What we deliberately do NOT cover at home but escalate directly to a paediatric clinic: infants under 3 months with any rectal fever above 38 °C (bacteraemia risk is time-critical), suspected meningitis (stiff neck, petechiae, photophobia), prolonged febrile seizure, marked respiratory distress with falling saturation, suspected acute abdomen (appendicitis, intussusception) and any unclear disturbance of consciousness. For these pictures we call 112 or accompany you straight to A&E — a private home visit is not the right place for hospital-grade diagnostics.

An important caveat: we do not replace paediatric continuity. Routine well-child checks, the STIKO vaccination plan, chronic pictures (asthma, allergies, developmental questions) and long-term care require a fixed paediatric practice. We are the acute element: when the paediatrician is unreachable but the child needs a review now. Ideally inform your paediatrician on the next working day about our visit — we can send a short doctor's letter on request.

Example: toddler with otitis on a Sunday evening

A two-year-old girl in Friedrichshain has been crying since noon, pulls at her right ear, fever 38.9 °C, still drinking. Her parents call on Sunday at 6 p.m. We arrive within 80 minutes, otoscopy shows a red, bulging eardrum on the right, normal on the left. Diagnosis: acute otitis media. Therapy: weight-adjusted ibuprofen syrup, watchful waiting for 48 hours with a clear escalation plan if no improvement, fever rises, or discharge appears — then antibiotic. Parents receive a prescription as a safety net for the next day. Follow-up by phone confirms two days later: otitis has resolved, antibiotic was not needed.

What we do (and do not do) on a paediatric house call

• Full physical examination: throat, ears, lungs, abdomen, lymph nodes, skin, orienting neuro-status.
• On-site rapid tests: influenza A/B, RSV, group A strep, urine dipstick for suspected UTI, blood glucose.
• Pulse oximetry and temperature measurement (rectal in infants, axillary from toddler age).
• Therapy initiation: symptomatic agents or, for clear bacterial indication, weight-dosed antibiotic.
• Clear safety-net counselling: we define together what to watch and when to call again or proceed straight to hospital.
• What we do NOT do: routine well-child checks (paediatric practice domain), imaging, surgical diagnostics.
• Escalation: if hospital review is indicated we can accompany you to the nearest paediatric A&E (Charité Virchow, Helios Buch, Vivantes Friedrichshain, DRK Westend).