The British guidelines for managing a feverish illness in a child less than 5 years old classifies clinical signs and symptoms into traffic colors that indicate the risk category.
|
Color |
Risk |
|
red |
high |
|
yellow |
intermediate |
|
green |
low |
|
Finding |
Green Light |
Yellow Light |
Red Light |
|
color of skin, lips and tongue |
normal |
slight pallor |
definite pallor, blue, ashen or mottled |
|
hydration |
normal |
dry mucous membranes |
poor skin turgor |
|
tachypnea |
none |
> 50 if 6-12 months; > 40 if > 12 months |
> 60 per minute |
|
breathing |
normal |
nasal flaring |
grunting |
|
chest indrawing |
none |
mild |
moderate to severe |
|
response to social cues |
normal, smiles |
abnormal, does not smile |
none |
|
level of consciousness |
normal |
needs to be roused |
does not waken or does not stay awake after stimulation stops |
|
activity |
normal |
decreased |
none |
Additional red light findings:
(1) bile stained (bilious) vomit
(2) >= 38°C if 0 to 3 months old; >= 39°C if 3 to 6 months old
(3) cry weak, continuous and/or high-pitched
(4) looks ill to a trained clinician
(5) non-blanching rash
(6) bulging fontanelle
(7) stiff neck
(8) status epilepticus
(9) focal seizures
(10) focal neurological signs
Additional yellow light findings:
(1) a new lump > 2 cm in diameter
(2) capillary refill time >= 3 seconds
(3) poor feeding in an infant
(4) reduced urine output
(5) fever >= 5 days
(6) oxygen saturation < 95%
(7) crackles on chest auscultation
(8) swelling of a limb or joint
(9) not using an extremity
(10) avoidance of weight-bearing on a lower extremity
Specialty: Pedatrics
ICD-10: ,
