Children between 1 month and 16 years presenting in primary care with acute illness were recruited from general practice surgeries in Oxfordshire and Somerset, between June 2007 and July 2009 (20 sampling periods of 1 week duration). The methods have been previously presented in detail.10 In summary, children were recruited at point of presentation for an appointment with a GP. Children with a final diagnosis inconsistent with an acute infection (for example, minor trauma, atopic eczema, asthma, allergic rhinitis, or infantile colic), those with obvious minor focal infections of the skin in whom there were no systemic symptoms or concern about systemic illness (for example, paronychia, local fungal infections, or verrucae), and those in whom there was insufficient information to determine a diagnosis were excluded. In the cohort analysed for the present study, the study did not exclude or include participants on the basis of a history or presence of fever. Parents completed a symptoms questionnaire on arrival, and GPs recorded their consultation as per usual practice. GPs were aware that the study was being conducted, but were unaware that the frequency of vital sign recording would be analysed.
How this fits in
Current guidelines recommend measurement of vital signs in children with acute infections however self-reported frequency of vital signs measurement has been poor among GPs. Numerical documentation of vital signs by GPs, in children presenting with acute infections, was poor, 31.6% of children had one or more numerical vital sign documented. Some GPs recorded words or phrases relating to vital signs instead of a numerical value, increasing the overall proportion of children with vital signs documented to 54.1%.Global assessment was documented in just one-third of consultations, even though this has been found to be highly predictive of serious infections.
