A
Over 90% of paediatric clinicians in the study considered the following behaviours in a febrile child to be reassuring signs that sepsis is unlikely:
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Age‑appropriate verbalisation (chatting, babbling)
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Playing or active energy (running, jumping)
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Smiling or laughing
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General activity and normal movement (PubMed)
Additionally, more than 70% agreed that these were also significant positive indicators:
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Eating or wanting to eat/drink
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Spontaneous interaction with others
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Presents with normal movement (ResearchGate, PubMed)
🚫 Behaviours that were not reassuring:
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Consolability (being easily consoled)
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Showing fear of the clinician
Respondents felt these were not adequate to rule out sepsis (PubMed, Australian Medical Association).
📱 Mixed views:
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The use of an electronic device (e.g., playing on a smartphone or tablet) yielded divided opinion — it may indicate wellness, but not reliably enough to reassure clinicians (PubMed).
Summary table
| Behaviour | Clinician consensus | Indicates wellness? |
|---|---|---|
| Age‑appropriate talking | > 90% | 👍 Yes |
| Playing / active energy | > 90% | 👍 Yes |
| Smiling / laughing | > 90% | 👍 Yes |
| General activity / movement | > 90% | 👍 Yes |
| Eating / wanting to eat/drink | > 70% | 👍 Yes |
| Spontaneous interaction | > 70% | 👍 Yes |
| Being easily consolable | — | 👎 Not trusted |
| Showing fear of clinician | — | 👎 Not trusted |
| Using an electronic device | Mixed opinions | 😐 Not reliable |
💡 Why this matters
Most sepsis tools focus on negative indicators like high heart rate or low blood pressure. This study emphasizes the value of positive, observed behaviours when considering whether a child is well—adding depth to clinical decision-making (PubMed, gppaedstips.blogspot.com, Don't Forget the Bubbles, Don't Forget the Bubbles).
🔜 Next steps
These findings suggest potential for incorporating positive behavioural markers into evaluation protocols. The authors propose prospective validation studies to assess how well these behaviours can rule out sepsis, enhancing specificity in diagnostic tools (PubMed).
In essence: When a child is talking, playing, smiling, active, eating, and interacting normally, clinicians are much more confident that sepsis is unlikely—though these signs shouldn't be used in isolation.
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