Parental concern | Parental concern |
|
Ill appearance | Clinician’s instinct something is wrong |
Clinically ill appearance |
|
ABC-instability | ABCD-instability |
|
Unconsciousness | Unconsciousness |
|
Drowsiness | Child is drowsy |
Somnolence |
Reactivity/functional status (decreased) |
Hypotonia |
|
Inconsolable | Child is inconsolable |
Irritability |
Changed crying pattern |
Child is moaning |
|
Abnormal circulation | Abnormal skin colour (pale, mottled, ashen) |
Capillary refill time >2 seconds |
Tachycardia |
|
Cyanosis | Cyanosis |
Oxygen saturation <95% |
|
Shortness of breath | Shortness of breath |
Nasal flaring |
Rapid breathing |
Changed breathing pattern |
|
Meningeal irritation | Meningeal irritation |
Neck stiffness |
Bulging fontanelle |
|
Neurological signs | Focal neurological signs |
Paresis/paralysis |
Seizures/fits |
|
Vomiting and diarrhoea | Vomiting (>2× in disease period) |
Diarrhoea (>2× in disease period) |
|
Dehydration | Dry mucous membranes |
Sunken eyes |
Decreased skin elasticity |
Reduced urine output |
Hypotension (APLs) |
Poor feeding |
|
Extremity problems | Swelling of limb or joint |
Non-weight-bearing limb |
Not using an extremity |
|
Signs of urinary tract infection | Pollakiuri |
Dysuria |
Abdominal pain (without other focus for fever) |
|
Petechial rash | Petechial rash |
Purpura |
|
Temperature ≥40°C | Measured at home or at a GPs’ cooperative out-of-hours service |
|
Duration of fever | Duration of fever in days at time of consultation |