Page 161 - 15Diarrhoeaandvomiting

Diarrhoea and vomiting caused by gastroenteritis in children under 5 years

Recommendations on escalation of care

During remote assessment:
• arrange emergency transfer to secondary care for children with symptoms suggesting
shock (see Table 4.6)
• refer for face-to-face assessment children:
– with symptoms suggesting an alternative serious diagnosis or
– at high risk of dehydration, taking into account recognised risk factors or
– with symptoms suggesting clinical dehydration or
– whose social circumstances make remote assessment unreliable
• provide a ‘safety net’ for children who do not require referral. The safety net should
include information for parents and carers on how to:
– recognise developing red flag symptoms (see Table 4.6) and
– get immediate help from an appropriate healthcare professional if red flag symptoms
develop.
During face-to-face assessment:
• arrange emergency transfer to secondary care for children with symptoms or signs
suggesting shock
• consider repeat face-to-face assessment or referral to secondary care for children:
– with symptoms and signs suggesting an alternative serious diagnosis or
– with red flag symptoms and/or signs of dehydration (see Table 4.6) or
– whose social circumstances require continued involvement of healthcare professionals
• provide a safety net for children who will be managed at home. The safety net should
include:
– information for parents and carers on how to recognise developing red flag symptoms
(see Table 4.6) and
– information on how to get immediate help from an appropriate healthcare professional
if red flag symptoms develop and
– arrangements for follow-up at a specified time and place, if necessary.

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