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Febrile serious illness — DCH MCQ

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HardPaediatric emergenciesFebrile serious illnessDCH

A 4-year-old with fever is assessed in urgent care. He is pale, has cold extremities, capillary refill 5 seconds, respiratory rate 44/min and oxygen saturation 92% in air. What is the most important red flag?

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Correct answer: D — Signs of shock with hypoxia

Prolonged capillary refill, cold extremities, tachypnoea and hypoxia are red features for serious illness and possible sepsis. Fever and reduced appetite are common and less discriminating when present without perfusion or respiratory compromise. The pearl is to integrate circulation and breathing observations rather than relying on temperature height.

Reference: NICE NG143; NICE NG254