Table 2

The initial Yale Score

Observation item1 – normal3 – moderate impairment5 – severe impairment
Quality of cryStrong with normal tone OR content and not cryingWhimpering or sobbingWeak OR moaning OR high pitched
Reaction to parent stimulationCries briefly then stops OR content and not cryingCries off and onContinual cry OR hardly responds
State variationIf awake stays awake OR if asleep and stimulated wakes up quicklyEyes close briefly OR awakes with prolonged stimulationFalls to sleep OR will not rouse
ColourPinkPale extremities or acrocyanosisPale OR cyanotic OR mottled OR ashen
HydrationSkin normal, eyes normal AND mucous membranes moistSkin, eyes – normal AND mouth slightly drySkin doughy OR tented AND dry mucous membranes AND/OR sunken eyes
Response (talk, smile) to social overturesSmiles 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