SCA practice case · Telephone consultation
“She’s got a temperature but she’s only 7 weeks — can I just give Calpol?”
Telephone consultation
Child patient
Someone else speaking
Hard
Children & young peopleUrgent & unscheduled care
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Lily · 7 weeks · female
Setting
Telephone — fever in a 7-week-old infant.
Past history
- Nil recorded
Medication
- None
Allergies
None recorded
Recent notes
⚠ 7 weeks old. 8-week immunisations not yet given.
Reason for contact
Mother requesting telephone advice: “Temperature 38.2 — can I just give Calpol?”
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
A temperature of 38°C or above in an infant UNDER 3 MONTHS is a NICE NG143 traffic-light RED feature in its own right — because young infants are at high risk of serious bacterial infection/sepsis and can deteriorate rapidly with few localising signs — so it mandates URGENT face-to-face assessment (paediatric/emergency) today, NOT home management with antipyretics. Antipyretics treat the number, not the cause, and do not make a febrile young infant safe; the age + fever is the trigger regardless of how the baby looks between feeds, and here the added features (more sleepy, feeding less) heighten concern. The examinable hidden agenda is a first-time mum minimising ("probably overreacting", "don’t want to drag a newborn to hospital") out of not wanting to be a nuisance while quietly terrified — validate her instinct explicitly (she did exactly the right thing), be unambiguous that this must be seen urgently, convey it calmly without paralysing panic, arrange the assessment now, and safety-net the 999 criteria (non-blanching rash, breathing difficulty, unresponsiveness, mottling, seizure).
The guidance behind it
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