 Observe Mental Status |
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| - Is the child alert? | |
| - Immediate response to parents? | |
| Alert = Non-urgent | |
| Other than alert = Urgent |
| Observe muscle tone and body position |
| Normal for age = Non-urgent |
| Examples: Young infants lying with flexed arms and legs Older children sitting comfortably |
| Anything else (floppy, stiff, unable to sit) = urgent |
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