Table 2

Scoring sheet for medical assessment (reproduced with permission from Professor Janet Treasure)

SystemTest/investigationYellow alertRed alert
NutritionBody mass index<2nd centile
Weight loss/week>0.5 kg>1.0 kg
Skin breakdown<0.1 cm0.2 cm
Purpuric rashPresent
CirculationSystolic BP<90 mmHg<80 mmHg
Diastolic BP<70 mmHg<60 mmHg
Postural drop>10 mmHg>20 mmHg
Pulse rate<50/min<40/min
MusculoskeletalUnable to get up without using arms as balanceYes
Unable to get up without using arms as leverageYes
Unable to sit up without using arms as leverageYes
Unable to sit up at allYes
Temperature<35°C (98.0°F)<34.5°C (97.0°F)
FBC (looking for bone marrow depression)WCC<4.0 x 109/l<2.0 x 109/l
Neutrophils<1.5 x 109/l<1.0 x 109/l
Hb<11.0 g/dl<9.0 g/dl
Acute Hb dropYes
Platelets<130 x 109/l<110 x 109/l
ElectrolytesPotassium<3.5 mmol/l<3.0 mmol/l
Sodium<135 mmol/l<130 mmol/l
Magnesium0.5–0.7 mmol/l<0.5 mmol/l
Phosphate0.5–0.8 mmol/l<0.5 mmol/l
Urea>7 mmol/l>10 mmol/l
Liver functionBilirubin20–40 μmol/l>40 μmol/l
Alk Phos *110–200 U/l>200 U/l
AST40–80 IU/l>80 IU/l
ALT45–90 U/l>90 U/l
GGT45–90 U/l>90 U/l
Albumin<35 g/l<32 g/l
CK>170 ng/ml>250 ng/ml
Glucose<3.5 mmol/l<2.5 mmol/l
ECGPulse rate<50<40
QTc>450 ms
  • * Range for infant to 16 years old, 60–425 U/l.5

  • ALT, alanine aminotransferase; AST, aspartate transaminase; BP, blood pressure; CK, creatine kinase; ECG, electrocardiogram; FBC, full blood count; GGT, gamma-glutaryl transferase; Hb, haemoglobin; QTc, corrected QT interval on ECG; WCC, white cell count.