What initial assessments should I perform for an adult presenting with

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Initial assessments for an adult presenting with fever to determine the underlying cause include:

Measure vital signs: temperature, heart rate, respiratory rate, blood pressure, oxygen saturation, and assess level of consciousness to identify severity and possible sepsis.
Examine for signs of sepsis or serious infection such as mottled or ashen appearance, cyanosis of skin, lips or tongue, non-blanching petechial or purpuric rash, breaches in skin integrity, or other rashes indicating infection.
Ask about recent fever or rigors and urinary output in the past 18 hours to assess systemic involvement and hydration status.
Consider the possibility of meningococcal disease or bacterial meningitis if there are signs such as non-blanching rash, neck stiffness, or altered consciousness, referring to specific NICE guidelines on these conditions.

These assessments help identify the underlying cause of fever and the presence of any life-threatening infections requiring urgent management .

What initial assessments should I perform for an adult presenting with fever to determine the underlying cause?