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Worried about “Seriousness” Speaker: Y. K. Amdekar
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a. Seriousness refers to likely danger to life and demands early recognition and prompt action. 

b. Life can be in danger is vital organs in particular do not receive adequate oxygen through effective circulation. Thus, it is important to assess adequacy of oxygenation and circulation in every sick child. 

c. If brain is not perfused adequately, there is change in behaviour – lethargy or irritability and if kidneys do not get sufficient supply, urine output goes down. 

d. Parents must be counselled to observe change in behaviour and urine output in every sickness and report immediately irrespective of cause of disease. 

e. Unexplained tachycardia and / or tachypnoea is the first warning of seriousness to a doctor. 

f. Besides, haemorrhagic skin rash or membrane on tonsil seriousness. Hence two observations by parents and two clinical signs can help in quick recognition of seriousness and every doctor must look for them.

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