When hearing a pleural rub in child's r lung, what co occurring symptoms determine child should go to doc on wkend? [5yo trach, baseline: clear ls]

Fever, cough, pain. In a child who has a tracheostomy, hearing pleural rubs on the right would be particularly concerning as this is the most common place to get a pneumonia in such individuals. If they have a fever, new lung sounds, pain or a new productive cough, it would be wise to seek the help of a physician soon in the event antibiotics are needed.
Overall illness. While there may be a change in physical exam, it depends on how ill the child is, especially with lung symptoms, as to best management. Fever, shortness of breath, increased and signficant trach secretions, cough, and low oxygen levels all merit at least a call to the doctor. Try to reach your regular doctor before heading to the emergency room.