Yale Scale for Febrile Child 3 to 36 months

Aka: Yale Scale for Febrile Child 3 to 36 months, Yale Observation Scale for Febrile Children, Yale Observation Scale, Yale Scale for Child with Fever, Febrile Child Evaluation with Yale Scale

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II. Indications

  1. Assessment of febrile child ages 3-36 months
  2. Predicts serious infection (Occult Bacteremia)
  3. Quantifies "Toxic Appearance" in children

III. 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%

IV. 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

V. References

  1. McCarthy (1982) Pediatrics 70:802-9 [PubMed]
  2. McCarthy (1985) Pediatrics 76:167-71 [PubMed]
  3. McCarthy (1987) J Pediatr 110:26-30 [PubMed]

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