Unwell Child Advice

Advice for unwell children

There is very useful and accurate guidance on how to judge when your child is unwell and required the attention of a doctor, you can use this to assess your own child in much the same way as your doctor will assess young children in the surgery. If you are concerned that your child is seriously unwell and may require hospital treatment please contact the surgery.

This written advice is available for free at http://www.whenshouldiworry.com

The NHS Child Health App is available here for iPhone and Android

Minor Head Injury Advice is available at NHS Choices Head Injury Advice

Fever advice from http://www.kevinmd.com/

Time off School or Nursery for Infections

Exclusion for five days:

• from rash onset - chickenpox* (NOTE: You can use ibuprofen for children with chicken pox if paracetamol alone is not effective), measles
• from starting antibiotics - whooping cough (pertussis)
• from onset of swollen glands - mumps

German measles (rubella):

• six days from onset of rash

Scarlet fever:

• child can return 24 hours after commencing appropriate antibiotic treatment
  • antibiotic treatment recommended for the affected child

Exclusion until condition has settled for 24 hours

• giardiasis; salmonella; shigella (Diarrhoeal illnesses)
  

Exclusion until lesions crusted or healed

• impetigo
  • until lesions are crusted and healed, or 48 hours after commencing antibiotic treatment

Shingles

• exclude only if rash is weeping and cannot be covered

Exclusion from school until treated

• scabies

With respect to hepatitis A:

• there is no justification for exclusion of well older children with good hygiene who will have been much more infectious prior to the diagnosis. Exclusion is justified for five days from the onset of jaundice or stools going pale for the under fives or where hygiene is poor.

With respect to gastroenteritis:

• children should not attend any school or other childcare facility while they have diarrhoea or vomiting caused by gastroenteritis
  • children should not go back to their school or other childcare facility until at least 48 hours after the last episode of diarrhoea or vomiting
  • children should not swim in swimming pools for 2 weeks after the last episode of diarrhoea.

Conditions where there is no recommended period to be kept away from school (once the child is well):

• influenza; cold sores (HSV); molluscum contagiosum; ringworm (tinea); athlete's foot; roseola; slapped cheek disease (parvovirus); warts and verrucae; conjunctivitis; glandular fever; head lice; non-meningiococcal meningitis; thread worm; tonsillitis.
• hand, foot and mouth disease

  • infected children should be kept away from school while they are unwell. The child should not be kept away from school till the last blister disappears, providing the child is well.