Table of Contents
A to E assessment
Note: Only move to the next letter when the one before has been treated, and keep re-assessing ABCDE from the start as necessary
Normal observations
| NORMAL | <1 year | 1-2 years | 2-5 years | 5-12 years | >12 years |
| Resp rate | 30-40 | 25-35 | 25-30 | 20-25 | 15-20 |
| Heart rate | 110-160 | 100-150 | 95-140 | 80-120 | 60-100 |
Amber and red flags
| Amber flags | Red flags | |
| A | Stridor | |
| B | Nasal flaring, tachypnoea, sats <95% | Respiratory distress (RR>60) |
| C | Pallor, tachycardia, reduced capillary refill, reduced UO, dry mucus membranes | Pale/mottled/blue, reduced skin turgor |
| D | Reduced activity, not responding normally to social cues | Unresponsive/won’t stay awake, non-blanching rash/neck stiffness, seizures |
| E | Rigors, fever in 3-6month old | Fever in <3month old |
Possible investigations
- Review child’s history in medical notes to help determine what is required
- Only do investigations that will change management
- BOXES
- Bloods: FBC, CRP, cultures, VBG, capillary blood gas (if low sats), glucose
- Orifice tests: urine dip and culture (parents to wait with sterile pot; in and out catheter may be used in young children if waiting too long); stool culture (if diarrhoea)
- X-rays/imaging: CXR (if respiratory signs)
- ECG (if HR>200 – ?SVT)
- Special tests: lumbar puncture (if <3months or very unwell or meningitis suspected)
- Any condition specific treatments
Request help as required
- Inform senior
Document in notes
- Document with a brief case summary, ABCDE headings with findings and management
- Review child and results as necessary
