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'Referral advice' recommendation details

Feverish illness in children

Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CG47 Children whose symptoms or combination of symptoms suggest an immediately life-threatening illness should be referred immediately for emergency medical care by the most appropriate means of transport (usually 999 ambulance). Children with any 'red' features but who are not considered to have an immediately life-threatening illness should be urgently assessed by a healthcare professional in a face-to-face setting within 2 hours. Children with 'amber' but no 'red' features should be assessed by a healthcare professional in a face-to-face setting. The urgency of this assessment should be determined by the clinical judgement of the healthcare professional carrying out the remote assessment. Immediate
CG47 Management of feverish illness in children should be carried out according to their assessed risk of serious illness. Management by a non-paediatric practitioner should start with a clinical assessment. Healthcare professionals should attempt to identify symptoms and signs of serious illness and specific diseases as summarised in tables 1 and 2 within guidance (Table 1: Traffic light system for identifying risk of serious illness, Table 2 Summary table for symptoms and signs suggestive of specific diseases). Children whose symptoms or combination of symptoms and signs suggest an immediately life-threatening illness should be referred immediately for emergency medical care by the most appropriate means of transport (usually 999 ambulance). 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. If any 'amber' features are present and no diagnosis has been reached, healthcare professionals should provide parents or carers with a 'safety net' or refer to specialist paediatric care for further assessment. The safety net should be one or more of the following: providing the parent or carer with verbal and/or written information on warning symptoms and how further healthcare can be accessed, arranging further follow-up at a specified time and place, liaising with other healthcare professionals, including out-of-hours providers, to ensure direct access for the child if further assessment is required. Children with 'green' features and none of the 'amber' or 'red' features can be managed at home with appropriate advice for parents and carers, including advice on when to seek further help. immediate
CG47 Children with fever who are shocked, unrousable or showing signs of meningococcal disease should be urgently reviewed by an experienced paediatrician and consideration given to referral to paediatric intensive care. Urgent

This page was last updated: 22 August 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.