Assessment of the unwell child.

BACKGROUND

Children present to general practitioners with a wide range of problems, but most of the time they are not particularly unwell. Children with a more serious illness often compensate very well initially, so there is a risk that their illness will be overlooked or underestimated.

OBJECTIVE

To outline the early recognition and management of children who are seriously ill.

DISCUSSION

The initial assessment of an unwell child includes the paediatric assessment triangle: appearance, breathing and circulation to skin; primary survey that focuses on basic life support, patient assessment and immediate management; secondary survey with a detailed history of the event and physical examination; and ongoing assessment. Medical practitioners and their clinic staff must be prepared to undertake initial emergency management of a seriously ill child, and they must have the equipment and supplies available to carry out that management effectively.