Was this a one time occurrence or have you noticed your gradaughter with this problem before.
This condition is know as cyanosis and is a sign that a child doesn't have enough oxygen in their blood. While often caused by congenital heart defects, it can also be caused by septic shock, seizures or lung problems, like pneumonia, asthma or croup.
Not all cyanosis is necessarily bad, though. Newborns and young infants can normally have acrocyanosis, with a bluish discoloration of their hands and feet. This is called peripheral cyanosis and usually goes away as a child’s circulatory system matures.
On the other hand, central cyanosis, where a child's face or trunk turns blue, is more likely to be caused by a serious problem. Specific signs of central cyanosis can be that a child is blue all over, or that his lips or tongue are blue.
While blue lips are a sign of central cyanosis, it can sometimes be normal for a child to get blue around his lips and mouth, especially when he is crying and screaming. In this case, his lips and tongue will still be pink though.
If your child is otherwise well, it is possible that it is just the skin around his lips that are becoming purple when he is running around inside. To see if that is the case, get a close look at his lips, tongue, and nail beds to see if they are pink, blue, or purple. If they are pink, then your child may just have circumoral cyanosis, which is cyanosis that can be seen around a child's mouth.
Some specific things to consider to help determine if this is normal or a real problem include:
# Is your child growing and developing normally? Weight loss or poor weight gain would be a sign that this is a more serious problem.
# Has your child ever been diagnosed as having a heart murmur?
# Does your child have any other symptoms, like a cough or trouble breathing, during these episodes, which might be a sign of asthma?
# Is your child not very active? Does she tire out very easily and before other children of his same age?
# Does she get weak and sleepy after these episodes of hard play or running?
Whether or not your child has any of these other signs or symptoms, he should have an evaluation by his pediatrician to look into this further. Your pediatrician may decide this is normal though, especially if your child has a normal physical exam and the pattern of the cyanosis seems to indicate that it is just circumoral cyanosis, and may not do any further testing.
If there is any question that this could be a sign of a more serious disorder, your pediatrician may do more testing, such as pulse oximetry to measure the oxygen level in your child's blood. Other testing might include a complete blood count, chest x-ray, and perhaps an EKG if he is worried about your child's heart.
The best advice I can give is to make an immediate appointment with her pediatrician. If this occurs over a weekend, I would proceed to the ER so she may have an immediate evaluation.