Heart rate is a key indicator of whether a childhood fever could represent a serious threat, according to guidance issued today.
Experts have added recommendations about heart rate to guidelines prepared by the UK’s National Institute for Health and Care Excellence.
The guidance seeks to help doctors identify which of hundreds of childhood fevers are likely to represent serious illness.
They also give advice on using common drugs to treat fever.
About a third of parents of young children will contact the health services about a case of fever every year.
The problem represents the second most common reason for hospital admission – as a few cases may indicate serious diseases such as meningitis or pneumonia.
The guidance says drugs such as paracetamol and ibuprofen will not prevent febrile convulsions – and should not be given together.
It says doctors can tell parents to switch drugs if one has no impact.
Paediatrician Dr Martin Richardson said: "The updated guideline has two major changes. The first is a revision of the well respected traffic light table of symptoms and signs. In particular, the inclusion of raised heart rate should lead to further improvements in the recognition of seriously ill children.
"The second major change is that the section on the treatment of fever has been rewritten to encourage the rational, stepwise use of drugs such as paracetamol and ibuprofen."
GP Dr John Crimmins added: “While dealing with children with fever is an everyday encounter in general practice, identifying the small number of those children who are in the early stages of a serious bacterial illness remains a difficult and challenging problem.
"As outcomes are largely dependent on early intervention, the initial assessments of these children, which can also occur in a variety of other settings including telephone advice lines, A&E and out-of-hours services, are crucial."
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