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Home > Worsening signs of a sick child

Worsening signs of a sick child

The action to take for each assigned colour

Green Amber Red
Normal/Low Risk Intermediate Risk High Risk
  Contact a health professional/GP 111 or 999 Contact 999

When checking your child use good light.

Consider their usual skin colour as darker skinned children do not always look pale.

As parents you know your child best;

Trust your own instincts

Useful websites

  • www.nhs.uk
  • www.sepsistrust.org
  • www.meningitis.org

Symptoms and their associated risk

Green

Normal/Low Risk

Amber

Intermediate Risk

Red

High Risk

Breathing
  • Normal
Breathing
  • Fast breathing, short of breath
  • Unusually noisy or wheezy when breathing
  • Flaring or widening of nostrils

Breathing

  • Finding it difficult to breath
  • Very fast breathing
  • Making unusual or grunting noises when breathing
  • Unusual patterns of breathing
  • Sucking in of chest or stomach

Colour

  • Normal colour of skin, lips and tongue

Colour

  • Unusually pale colour of skin, lips and tongue for your child
  • Sunken eyes with dark circles

Colour

  • Very pale, grey or blue skin, lips or tongue
  • Rash, red or purple that does not fade

Activity

  • Responds normally to interaction with parent and surroundings
  • Smiles
  • Stays awake or wakes quickly
  • When cries it is strong/normal or not crying

Activity

  • Not responding normally to family or carers
  • Not smiling
  • Difficult to wake up or unusually sleepy
  • Not wanting to do very much

Activity

  • Not responding to carers
  • Very difficult to wake up, drowsy less responsive
  • Child is weak or floppy
  • Child has a fit
  • High-pitched or continuous cry in younger children

Eating and drinking

  • Taking usual foods and fluids
  • Normal skin and eyes
  • Moist lips and gums

Eating and drinking

  • Not feeding very much
  • Dry lips and mouth
  • Reduced weeing or fewer wet nappies than normal

Eating and drinking

  • Unable to keep feeds or fluids down
  • No wee or wet nappy for 12 hours or more
  • Very few wees or wet nappies
  • Very thirsty

Temperature and body

  • Normal temperature
  • 36.4-37.5 degrees

Temperature and body

  • Raised temperature for 5 days or more
  • Shivering or shaking
  • Babies aged 3-6 months with any recorded temperature of 39 degrees or above
  • Hands and feet are unusually cold to touch
  • Temperature of below 36 degrees
  • New lump greater than 2cm

Temperature and body

  • Babies under 3 months with any recorded temperature of 38 degrees or above
  • Stiff neck especially when trying to look up or down
  • Hands and feet are mottled and very cold to touch
  • Bulging soft spot on head in infants

 

Last Updated 21 Mar 2025

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