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.
Dr Yeshwant Amdekar is one of the senior most practicing pediatricians in India having been in paediatric practice for last 47 years. He served as a teacher at Grant Medical College for 30 years and retired as a professor of Pediatrics in the year 2000. He has taught an entire generation of paediatricians and continues to do so even today.
He is presently Medical Director of the B.J.Wadia Hospital for children which is Mumbai's only dedicated and largest children's hospital. He was President of the Indian Academy of Pediatrics in the year 1995 and has served the academy in various positions. He has also authored four books and has contributed articles in indexed journals and chapters in textbooks. He has been a recipient of many prestigious orations.
Dr Amdekar has been a great source of encouragement to young paediatricians as well as development of paediatric sub-specialities including paediatric hepatology.