Red Flags

2- Severe Lethargy and Altered Consciousness

1- Fever in Neonates and Children

Fever in neonates and young children may indicate a serious underlying infection. Fever is considered dangerous in neonates (≤28 days) and always requires urgent medical evaluation. In older children, fever becomes concerning when associated with alarming symptoms. Misconceptions such as delaying care or focusing only on fever reduction can be harmful.

Warning signs include:

Any fever in neonates (≤28 days) is an emergency
Poor feeding, persistent vomiting, or rash
Breathing difficulty or abnormal behavior
Fever is a symptom, not the disease
Antipyretics do not treat the underlying cause

2- Severe Lethargy and Altered Consciousness

Severe lethargy and altered mental status are always abnormal in children and may signal a life-threatening condition. A child who is unusually sleepy, difficult to arouse, or not responding normally requires immediate assessment.

Concerning features:

Child is difficult to wake or unresponsive
Sudden change in behavior or alertness
Poor interaction with caregivers
Possible causes include infection, hypoglycemia, or CNS disease
Requires urgent medical evaluation

3- Severe Dehydration

Severe dehydration is a life-threatening condition, especially in infants and young children. It usually results from prolonged diarrhea, vomiting, or inadequate fluid intake and requires urgent intervention.

Red flag signs:

Sunken eyes and dry mouth
Poor skin turgor
Minimal or absent urine output
Lethargy or weakness
Needs emergency treatment, often IV fluids

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