Here’s an example of something that is useful but fairly simplistic.
This tells us what normal and abnormal look like. It does very little to tell us what it all means. Stopping here would be fine if we are just going to tell people when to refer or not. To do that safely, such guidance will inevitably err on the side of caution.
What it fails to do is to address what may be causing the red flags or atypical findings. While a diagnosis is not necessary in order to make a decision to refer, having a suspected diagnosis helps us to get the right child to the right place at the right time.
Let’s take two of the possible complex and dangerous diagnoses as examples. A child has a febrile illness with conjunctivitis, pharyngitis, swollen lymph nodes, a rash and is pretty miserable. Good to know. If I told you that the onset of symptoms was within the past 24hrs, would you consider Kawasaki disease?