Paediatrics Emergency Medicine Strong — NICE NG143

Yale Observation Scale (YOS)

Six-item observational scale to identify seriously ill febrile children aged 3–36 months. Scores ≤10 suggest low risk of serious illness.

Score interpretation

Low Risk 6–10

YOS 6–10: Low risk of serious illness (risk ~3%).

→ Manage as per NICE NG143 febrile illness algorithm. Safety net parents. Can be managed in community if fever source identified and child feeding well.

Intermediate Risk 11–15

YOS 11–15: Intermediate risk of serious illness (~26%).

→ Full septic screen: FBC, CRP, blood culture, urine MC&S, CXR if respiratory. Paediatric review. Consider empirical antibiotics if no source and high CRP.

High Risk — Serious Illness Likely 16–30

YOS 16–30: High risk of serious illness (~92%).

→ URGENT paediatric assessment. IV access. Full septic screen. Empirical IV antibiotics (ceftriaxone 50 mg/kg). Resuscitation as required. Consider PICU referral.

Interpretation bands for the Yale Obs Scale. Apply clinical judgement and local guidance.

References

McCarthy PL et al. Observation scales to identify serious illness in febrile children. Pediatrics. 1982.
NICE NG143. Fever in under 5s: assessment and initial management. 2019.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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