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'Red flags' to spot serious infections in young outlined


Researchers have identified a series of “red flag” symptoms that will help clinicians to diagnose children with serious infections such as meningitis.

Rashes, quick breathing and poor blood circulation can all point to a child suffering from more than a minor cold, said the researchers writing in the The Lancet. They also warned clinicians to look out for children with a temperature over 40 oC.

The authors said that becasue serious infections such as meningitis, pneumonia and sepsis were now rare in developed countries, they were becoming more difficult to diagnose in children as clinicians were less likely to encounter them and therefore recognise the symptoms.

Study co-author Dr Matthew Thompson, from Oxford University, said: “It’s a bit like finding a needle in a haystack. Serious infections are rare and getting increasingly rarer thanks to vaccinations. Identifying that one child out of all those many with minor ailments is difficult. It is complicated further as the child may be seen at any early stage of infection before it is possible to recognise its severity.”

The researchers now want to develop guidelines for GPs so that children with infections are referred to hospitals quickly and only when necessary.

Dr Ann Van den Bruel, another member of the Oxford team, said: “Health professionals should routinely check for these warning signs in every sick child they see. For example, not all GPs will check a child’s temperature, whereas we would now suggest this is done on all occasions.”



Readers' comments (2)

  • Why Bother ?

    Both myself and my wife are nurse, our son 4 (an unstable asthmatic) had been unwell for a few days, we were woken at 3:00 with difficult breathing / adgitation, and were surprised to read a temperature of 40.3 knowing he had had paracetamol and ibuprofen at midnight. Called OOH Dr who came out - most cursary exam I have ever seen (just listened to his chest) diagnosed Chest infection px amoxil. Next day saw own GP due to further problems, temp recorded as 38 (having not been taken by OOH Dr) with comment worried parents, so if they are going to make it up all the red falgs in the world will not save a child from a lazy ?incompetant Dr.

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  • Maybe I have missed the point here but surely any clinician qualified in assessing and treating a poorly child should be well aware of the red flags for unwell children? in conjuction with those listed in your article raised pulse rate is also a sign of an unwell child but I would be very concerned if a clinician could not tell these basic four signs of a child needing emergency care? I am a nurse practitioner in a busy gp training surgery - even the medical students are aware of the signs and symptoms.

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