Red flags

If a child has symptoms of meningitis or septicaemia (blood poisoning), they need urgent medical attention.

Signs of meningitis include:

• Flu-like symptoms 
• A stiff neck
• A bad headache
• Dislike of bright lights 
• Fever 
• Vomiting 
• Drowsiness/reduced responsiveness 
• Convulsions/fits 
• A rash that doesn’t fade when a glass is rolled over it
• Babies/toddlers may refuse to eat, not want to be touched or held, have a tense or bulging fontanelle, a stiff body with jerky movements or be floppy. 

Signs of septicaemia include: 

• Blue, pale or blotchy skin, lips or tongue
• A rash that doesn’t fade when a glass is rolled over it
• Difficulty breathing, breathlessness or breathing very fast
• A weak, high-pitched cry that’s not like their normal cry
• Not responding like they normally do, or not interested in feeding or normal activities 
• Being sleepier than normal or difficult to wake. 

When to refer

In addition to your pharmacy protocol, you should also refer to the pharmacist any child who: 

• Is under six months old and has a fever 
• Is not feeding 
• Is vomiting green fluid 
• Has blood in their faeces 
• Has a persistent high temperature despite treatment 
• Has suspected signs of septicaemia or meningitis 
• Makes a grunting noise when breathing 
• Has a constant, inconsolable or high-pitched cry 
• Has pale, blue/grey/ashen/mottled skin 
• Has a fit associated with a fever 
• Has signs of dehydration, such as fewer wet nappies 
• Has symptoms that haven’t improved as expected.