Dry mucous membrane Poor feeding in infants 3 seconds CRT ≥ Reduced urine output OTHER None of the amber Age 3-6 months, Age 0-3 months, or red signs or temperature 390c temperature 380c ≥ ≥ symptoms Rigors Non blanching rash Fever to 5 days Bulging fontanelle ≥ Swelling to limb or Neck stiffness joint Status epilepticus Non-weight Focal neurological bearing/not using signs an extremity Focal seizures Children with any features but who are not considered to have an ‘RED’ immediately life threatening illness should be referred urgently to the care of a paediatric specialist. Children with any features and no diagnosis has been reached, ‘AMBER’ healthcare professionals should provide patients or carers with a or ‘safety net’ refer to a specialist paediatric care for further assessment Children with features only can be managed at home with appropriate ‘GREEN’ advice for parents and carers, including when to see further attention from the healthcare services. When assessing children with learning disabilities, take the individual child's learning disability into account when interpreting the traffic light table Do not use duration of fever to predict the likelihood of serious illness. However, children with a fever lasting more than 5 days should be assessed for Kawasaki disease http://www.nhs.uk/conditions/Kawasaki-disease/Pages/Introduction.aspx (see recommendation 1.2.3.10 NICE 2013) Recognise that children with tachycardia are in at least an intermediate-risk group for serious illness. Use the Advanced Paediatric Life Support (APLS) criteria below to define tachycardia: [NICE guidance .2.2.13 new 2013] Age Heart rate (bpm) <12 months >160 12–24 months >150 2–5 years >140 Recognise that a capillary refill time of 3 seconds or longer is an intermediate-risk group marker for serious illness ('amber' sign).
Dry mucous membrane Poor feeding in infants CRT ≥ 3 seconds Reduced urine output OTHER None of the amber or red signs or symptoms Age 3-6 months, temperature ≥ 390c Rigors Fever to ≥ 5 days Swelling to limb or joint Non-weight bearing/not using an extremity Age 0-3 months, temperature ≥ 380c Non blanching rash Bulging fontanelle Neck stiffness Status epilepticus Focal neurological signs Focal seizures Children with any ‘RED’ features but who are not considered to have an immediately life threatening illness should be referred urgently to the care of a paediatric specialist. Children with any ‘AMBER’ features and no diagnosis has been reached, healthcare professionals should provide patients or carers with a ‘safety net’ or refer to a specialist paediatric care for further assessment Children with ‘GREEN’ features only can be managed at home with appropriate advice for parents and carers, including when to see further attention from the healthcare services. When assessing children with learning disabilities, take the individual child's learning disability into account when interpreting the traffic light table Do not use duration of fever to predict the likelihood of serious illness. However, children with a fever lasting more than 5 days should be assessed for Kawasaki disease http://www.nhs.uk/conditions/Kawasaki-disease/Pages/Introduction.aspx (see recommendation 1.2.3.10 NICE 2013) Recognise that children with tachycardia are in at least an intermediate-risk group for serious illness. Use the Advanced Paediatric Life Support (APLS) criteria below to define tachycardia: [NICE guidance .2.2.13 new 2013] Age Heart rate (bpm) <12 months >160 12–24 months >150 2–5 years >140 Recognise that a capillary refill time of 3 seconds or longer is an intermediate-risk group marker for serious illness ('amber' sign).