How GPs identify sick children.
08 October 2012
A study funded by Meningitis Research Foundation (MRF) and published last week in the British Journal General Practice highlights how and when GP’s record vital signs in children with acute infections.
One of the major issues surrounding meningitis and septicaemia is spotting the signs and symptoms early and getting medical treatment as soon as possible. MRF funded Dr Matthew Thompson, GP and Senior Clinical Scientist at the University of Oxford, to compare the symptoms seen by parents of children in the early stages of meningitis and septicaemia with those seen in children with common infections. The aim was to see if there were any specific symptoms that could distinguish meningitis and septicaemia from milder illnesses.
In the study of children with common infections, Dr Thompson also investigated what signs and symptoms GPs consider, and found that vital signs such as temperature and pulse were seldom taken by GP’s.
Dr Thompson commented: “We wanted to find out how often GPs measure children’s vital signs such as heart rate, breathing rate or temperature when they see a child in their surgery. NICE recommends GPs should do this when they see an unwell child under 5 yrs of age, but we didn’t know how often this actually happens. The study found that nearly ¾ (71%) of children coming in to see their GP with an acute infection did not have their vital signs recorded. GPs seem to rely more on looking at the child’s overall activity and behaviour.
The focus for parents and GPs is being able to spot the child who could have any serious illness or serious infection. Relying on how active or alert a child appears, is still incredibly important. But, GPs need more accurate and faster devices to measure vital signs in children – these are available, but no-one has really tested them thoroughly enough. These could even let parents measure their child’s vital signs themselves. However, we also need to know what these “numbers” mean – in other words, how worried should parents and GPs be if a child has a certain heart rate or breathing rate? This is something we urgently need answers to.”
Linda Glennie, Head of Research and Medical Information at MRF said: “This research shows that GPs focus on the activity and behaviour of a child, and what the parent is most worried about. It is therefore really important for parents to be able to tell their doctor when they call up or visit the surgery about what exactly is worrying them, and how their child’s activity is different from usual. We know that when GPs and parents have a “gut feeling” that something serious is wrong, they should take notice of this and act on it as time is of the essence when treating patients with meningitis or septicaemia.”
This latest research by Dr Thompson leads on from a previous MRF funded project – the largest health care delivery study for meningitis and septicaemia to date – that identified the vital ‘red flag’ symptoms
for meningitis and septicaemia in children. The results are used as the basis for MRF’s life-saving resources for GPs, hospitals and parents in trying to improve early recognition and treatment for these devastating diseases. These latest results highlight the need to measure and record vital signs and that parents and GPS should trust their instincts to catch meningitis and septicaemia early.