Calculator · Paediatrics

Fever in under 5s — NICE NG143 traffic-light checker

Tick the features present; shows the highest traffic-light band reached and the NICE NG143 position. No drugs or doses.

What it is for

Children under 5 with a fever. NICE NG143 (2019, updated 2021) traffic-light system for identifying risk of serious illness. Reference only: clinical judgement, the full NG143 table and specific-illness assessments (for example meningococcal disease, UTI, Kawasaki disease) still apply.

Use the working calculator

The working Fever in under 5s — NICE NG143 traffic-light checker calculator is on our calculators page. It is free and needs no account. Enter the values and it shows the result with the reading that goes with it.

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What you enter

The calculator asks for 16 items.

Immediately life-threatening

  • Compromised airway, breathing or circulation, or decreased level of consciousness

RED features (high risk)

  • Colour: pale, mottled, ashen or blue (skin, lips or tongue)
  • No response to social cues; appears ill to a healthcare professional
  • Does not wake, or if roused does not stay awake
  • Weak, high-pitched or continuous cry
  • Grunting; respiratory rate > 60 /min; moderate or severe chest indrawing
  • Reduced skin turgor
  • Age 0–3 months with temperature ≥ 38°C
  • Non-blanching petechial or purpuric rash; bulging fontanelle; neck stiffness; status epilepticus; focal neurological signs; focal seizures

AMBER features (intermediate risk)

  • Pallor of skin, lips or tongue reported by parent or carer
  • Not responding normally to social cues; no smile; wakes only with prolonged stimulation; decreased activity
  • Nasal flaring; respiratory rate > 50 /min (6–12 months) or > 40 /min (over 12 months); SpO₂ ≤ 95% in air; crackles in the chest
  • Heart rate > 160 (under 12 months), > 150 (12–24 months) or > 140 (2–5 years) /min
  • Capillary refill time ≥ 3 seconds; dry mucous membranes; poor feeding in infants; reduced urine output
  • Age 3–6 months with temperature ≥ 39°C
  • Fever for ≥ 5 days; rigors; swelling of a limb or joint; non-weight bearing or not using an extremity

How the result is read

The result is shown as Highest band reached.

Sources

These are the sources the calculator cites. Check the current version before relying on a threshold.

Related

Corrected age (prematurity)Chronological and corrected age for an infant born preterm.CHA₂DS₂-VAScStroke risk score in non-valvular AF.HAS-BLEDMajor bleeding risk on anticoagulation for AF.ORBITAlternative bleeding risk score for AF — may outperform HAS-BLED.QRISK3 (10-year CV risk)Predicts 10-year risk of MI / stroke. Proprietary algorithm. For education and practice only. For patient care, use the QRISK3 tool built into your clinical system (NICE NG238).All calculators60 clinical scores and tools

For qualified clinicians. A score supports a clinical decision and does not make it: check the inputs, read the cited source, and use the tools in your clinical system for patient care where one is provided.