Infectious Disease Book

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Yale Observation Scale

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  1. Indications
    1. Assessment of febrile child ages 3-36 months
    2. Predicts serious infection (Occult Bacteremia)
    3. Quantifies "Toxic Appearance" in children
  2. Interpretation
    1. Score = 10
      1. Incidence serious illness: 2.7%
    2. Score = 11-15
      1. Incidence serious illness: 26%
    3. Score >16
      1. Incidence serious illness: 92.3%
  3. Scoring
    1. Quality of Cry
      1. Strong or No cry: 1
      2. Whimper or Sob: 3
      3. Weak cry, Moan, or high pitched cry: 5
    2. Reaction to parents
      1. Brief Cry or Content: 1
      2. Cries off and on: 3
      3. Persistent cry: 5
    3. State variation
      1. Awakens quickly: 1
      2. Difficult to awaken: 3
      3. No arousal or falls asleep: 5
    4. Color
      1. Pink: 1
      2. Acrocyanosis: 3
      3. Pale, Cyanotic, or Mottled: 5
    5. Hydration
      1. Eyes, skin, and mucus membranes moist: 1
      2. Mouth slightly dry: 3
      3. Mucus Membranes dry, eyes sunken: 5
    6. Social Response
      1. Alert or Smiles: 1
      2. Alert or brief smile: 3
      3. No smile, anxious, or dull: 5
  4. References
    1. McCarthy (1982) Pediatrics 70:802
    2. McCarthy (1985) Pediatrics 76:167
    3. McCarthy (1987) J Pediatr 110:26

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