Serious Illnes under 5 years 

domingo, 24 de abril de 2022  06:41 p. m. 

High Risk:  Intermidiate: 

Pale Skin  Pallor (?) 
Blue lips/cyanosis/ ashen pale mottled (livedo reticularis) Not responding to social cues 
skin  No smile 
No response to social cues  Wakes only to stimulation 
Appearing ill  Decreased acvtivity 
Does not awake or refuse to stay awake  Nasal Flaring(?) 
Chest in drawing  Poor feedind 
Bludging Fontanelle  Reduced urine output 
Grunting  Rigors 
Respiratory Rate >60 per minute  3 seconds or more of capilliary refill 
Reduced skin turgor  Tachycardia!!! 
Any fever under 3 months should be investigated. 

What is normal?  Vital Sings 

Any child in the abscence of high and intermidial risk W/ the following: 
-Normal skin, lips and tongue tone  RR  Age  HR  Age 
Normal skin and eyes 
>60  0-5 mo  >160  0-12
-Strong normal crying or no crying 
mo 
-Moist mucous membrane 
-Smiles  >50  6-12 >150  12-24
-Stays awake  mo  mo 
-Responds normally to social cues  >40  >12 >140  2-5 y 
mo 

Pneumonia! 
-Chest indrawing   
Special considerations:  -Nasal flarin  Kawasaki disease: 
Meningococcal bacteremia  -Tachypnea  Fevero over 39°C with 4: 
Consider any child with fever and non bleaching rash. Particularly IF:  -Cyanosis  -Orofaryngeal changes. 
Ill looking  -<95% or less Sat  -Erithema of lips 
>2mm petequia (purpura)  -Crackles in the chest  -Bilateral conjutivitis /No bacterial 
A capillary refill 3 secons or more    -Polymorphous rash 
NECK STIFFNESS remembering the TRIAD (NECK, FEVER and HEADACHE)     -Edema and erithema in hands and feet doesn't respect palms 
BULDING FONTANELE  -Cervical lymphadenopathy. 
UTI:  
CONVULSIVE STATUS EPILEPTICUS   
Any child younger than 3
IN KIDS: FEVER ALREADY IN!! 
month With FEVER!! 
NECK 
--Older than three month has to
HIGH PITCHED CRY 
have at least: 
FONTANELL 
-Poorfeding 
-Vomiting 
-Urinary frenquency or dysuria 
-Lethargy 
Herpex Simplex Encephalitis: 
-Irritability 
-Focal neurological Signs 
-Abdominal pain ot tenderness
-Focal Seizures 
(Must diffirintiate with
-Decreased Level os consiusness (Cranial Hipertension ?) 
apendicitis)