Pulse rate tool helps GPs spot meningococcal disease
By Lilian Anekwe
Measuring pulse rate as part of a new diagnostic tool can help GPs identify children with febrile illnesses potentially at risk of meningococcal disease, a new study suggests.
GP researchers have developed charts designed to help spot feverish children with more serious infections, by identifying those with a higher than expected pulse rate for their age and temperature.
NICE recommended last year that GPs should measure temperature, pulse rate, respiratory rate and capillary refill time, and apply them to a ‘traffic light' system to predict the risk of serious illness.
The researchers analysed 1,589 children with upper and lower respiratory tract infections, non-specific viral illnesses, or diarrhoea and vomiting.
They plotted charts of pulse rate against temperature, to determine the normal range of temperatures for a child of a certain age with fever.
Children's pulse rate increased by between 9.9 and 14.1 beats/min with each 1?C increase in temperature, depending on their age, which the researchers said GPs should use in the initial assessment of children with acute infections.
Their study, published online by Archives of Diseases in Childhood, concluded: ‘The charts present a simple visual method to allow clinicians to identify children who have a higher pulse rate than would be expected for their age and temperature'.
Study leader Dr Matthew Thompson, a GP in Oxford and clinical lecturer in general practice at the University of Oxford, told Pulse: ‘The research tries to address the gaps in NICE guidance and gives GPs some evidence which is more useful rather then having a blanket statement about a range of vital signs to look for.
‘These provide new reference standards for pulse rate in children with fever. GPs won't use this tool in isolation, but if a child is in the 90th or 97th centile, that should act as a prompt to investigate that child more thoroughly and monitor them more closely.'
Dr John Crimmins, a member of the NICE childhood fever guideline development group and a GP in Llantwit Major, south Wales, said: ‘Pulse rate in children is something that we as GPs should be taking more note of. But it's just one part of the jigsaw – it would be interesting to know how predictive an elevated pulse rate is of meningococcal disease.'Pulse rate values