Nelson reported an index for evaluating a pediatric patient with acute non-traumatic illness in the Emergency Department (ED). This can help to determine how severe a child's illness is. The author is from Yale University and the score predates the Yale Observation Scale (YOS).
Patient selection: acute non-traumatic illness in the ED
Parameters:
(1) respiratory effort
(2) color
(3) activity
(4) temperature in °F
(5) play
|
Parameter |
Finding |
Points |
|
respiratory effort |
no distress |
2 |
|
|
some distress |
1 |
|
|
labored or absent |
0 |
|
color |
normal |
2 |
|
|
pale, flushed, mottled |
1 |
|
|
cyanotic |
0 |
|
activity |
normal |
2 |
|
|
lethargy |
1 |
|
|
delirium, stupor |
0 |
|
temperature |
97.4 to 101°F |
2 |
|
|
101.1 to 104°F |
1 |
|
|
< 97.4 or > 104°F |
0 |
|
play |
normal |
2 |
|
|
decreased |
1 |
|
|
refused to play |
0 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The lower the score the sicker the child.
|
Score |
Severity |
|
10 |
not sick |
|
8 or 9 |
moderately sick |
|
<= 7 |
very sick |
Performance:
• The false positive prediction rate was 16%
• The false negative false negative prediction rate was 1.3%, with predictive accuracy for nonsevere illness at 98.7%.
Specialty: Pedatrics
