The initial Yale Score
| Observation item | 1 – normal | 3 – moderate impairment | 5 – severe impairment |
|---|---|---|---|
| Quality of cry | Strong with normal tone OR content and not crying | Whimpering or sobbing | Weak OR moaning OR high pitched |
| Reaction to parent stimulation | Cries briefly then stops OR content and not crying | Cries off and on | Continual cry OR hardly responds |
| State variation | If awake stays awake OR if asleep and stimulated wakes up quickly | Eyes close briefly OR awakes with prolonged stimulation | Falls to sleep OR will not rouse |
| Colour | Pink | Pale extremities or acrocyanosis | Pale OR cyanotic OR mottled OR ashen |
| Hydration | Skin normal, eyes normal AND mucous membranes moist | Skin, eyes – normal AND mouth slightly dry | Skin doughy OR tented AND dry mucous membranes AND/OR sunken eyes |
| Response (talk, smile) to social overtures | Smiles OR alerts (<2 mo) | Brief smile OR alerts briefly (<2 mo) | No smile OR face anxious, dull or expressionless OR no alerting (<2 mo) |
Source: McCarthy PL, Sharpe MR, Spiesel SZ, et al. Observation scales to identify serious illness in febrile children.8