The SICK score (Signs of Inflammation in Children that can Kill) can be used to identify a sick child who may require more aggressive management. It is a severity of illness scale that incorporates features of the systemic inflammatory response syndrome (SIRS). The authors are from All India Institute of Medical Science in New Delhi.
The score is derived from a previous score reported by several of the authors (Kumar et al, 2003).
Patient selection: sick child from 1 month to 12 years of age without congenital malformations
Parameters:
(1) body temperature in °C
(2) heart rate in beats per minute
(3) respiratory rate in breaths per minute
(4) systolic blood pressure in mm Hg
(5) percutaneous oxygen saturation in percent
(6) capillary refill time in seconds
(7) consciousness by AVPU (alert, responds to voice, responds to pain, unresponsive)
(8) infant or child
|
Parameter |
Finding |
Points |
|
body temperature |
< 36°C |
1 |
|
|
36 to 38°C |
0 |
|
|
> 38°C |
1 |
|
heart rate |
infant and <= 160 per minute |
0 |
|
|
infant and > 160 per minute |
1 |
|
|
child and <= 150 per minute |
0 |
|
|
child and > 150 per minute |
1 |
|
respiratory rate |
infant and <= 60 per minute |
0 |
|
|
infant and > 60 per minute |
1 |
|
|
child and <= 50 per minute |
0 |
|
|
child and > 50 per minute |
1 |
|
systolic blood pressure |
infant and >= 65 mm Hg |
0 |
|
|
infant and < 65 mm Hg |
1 |
|
|
child and >= 75 mm Hg |
0 |
|
|
child and < 75 mm Hg |
1 |
|
oxygen saturation |
>= 90% |
0 |
|
|
< 90% |
1 |
|
capillary refill time |
< 3 seconds |
0 |
|
|
>= 3 seconds |
1 |
|
consciousness by AVPU |
alert |
0 |
|
|
responds to voice |
1 |
|
|
responds to pain |
1 |
|
|
unresponsive |
1 |
total SICK score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum SICK score: 0
• maximum SICK score: 7
• The higher the score the greater the mortality rate.
|
SICK score |
Mortality Rate |
|
0 |
0% |
|
1 |
5% |
|
2 or 3 |
12% |
|
4 |
20% |
|
5 |
60% |
|
6 or 7 |
100% |
Specialty: Pedatrics
ICD-10: ,
