NICE 'traffic light' guidance helps to assess child fever

GPs should use a 'traffic light' system for assessing children with fever, according to guidance issued by NICE this week.

Between 20 and 40 per cent of parents of under-fives seek healthcare for their children's feverish illnesses each year in England and Wales. But there was previously no national guidance on the management of fever.

The NICE guidance aims to reduce the number of hospital admissions for fever, the second most common reason for a child being admitted to hospital, by providing a practical tool to assess fever symptoms.

The guidance states that measurements of body temperature, heart rate, respiratory rate and capillary refill should be carried out to detect feverish illness in children younger than five.

Children with feverish illness and any of the symptoms or signs in the red column of the traffic light system, such as severe chest indrawing and weak, continuous crying, should then be recognised as being at immediate risk of serious illnesses like meningitis or pneumonia. They should be seen by a GP in a face-to-face setting within two hours.

Children with fever and any of the symptoms in the amber column, but none in the red, should be recognised as being at immediate risk, while children with symptoms found only in the green column are deemed to be at low risk of serious illness.

Children with green symptoms should be sent home with appropriate advice provided to the patients or carers.

Traffic light system

Red high-risk symptoms
Severe chest indrawing, weak, continuous crying

Amber immediate-risk symptoms
Nasal flaring, reduced urine output. 

Green low-risk symptoms
Moist mucous membranes.

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