title: When and how do GPs record vital signs in children with acute infections? A cross-sectional study.
abstract: BACKGROUND
  NICE recommendations and evidence from ambulatory settings promotes the use of vital signs in identifying serious infections in children. This appears to differ from usual clinical practice where GPs report measuring vital signs infrequently.
  
  
  OBJECTIVE
  To identify frequency of vital sign documentation by GPs, in the assessment of children with acute infections in primary care.
  
  
  METHODS
  Observational study in 15 general practice surgeries in Oxfordshire and Somerset, UK.
  
  
  METHODS
  A standardised  proforma was used to extract consultation details including documentation of numerical vital signs, and words or phrases used by the GP in assessing vital signs, for 850 children aged 1 month to 16 years presenting with acute infection.
  
  
  RESULTS
  Of the children presenting  with acute infections 31.6% had one or more numerical vital signs recorded (269, 31.6%), however GP recording rate improved if free text proxies were also considered: at least one vital sign was then recorded in over half (54.1%) of children. In those with recorded numerical values for vital  signs, the most frequent was temperature (210, 24.7%), followed by heart rate (62, 7.3%), respiratory rate (58, 6.8%), and capillary refill time (36, 4.2%). Words or phrases for vital signs were documented infrequently (temperature 17.6%, respiratory rate 14.6%, capillary refill time 12.5%,  and heart rate 0.5%), Text relating to global assessment was documented in 313/850 (36.8%) of consultations.
  
  
  CONCLUSIONS
  GPs record vital signs using words and phrases as well as numerical methods, although overall documentation of vital signs is infrequent in children presenting  with acute infections.
authors.affiliation: Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Blacklock
authors.forename: Tanya Ali
authors.initials: TA
authors.lastname: Haj-Hassan
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Thompson
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004739:England; D005334:Fever / Q000175:diagnosis; D058006:General Practice; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008499:Medical Records / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D063189:Symptom Assessment / Q000379:methods / Q000706:statistics & numerical data; D055986:Vital Signs