Initial health check
Updated: 10 November 2011
This resource helps with identifying those children and young people who are in need of urgent medical attention.
This initial health check, using the decision tree (below), helps the social worker identify those conditions for which the child or young person should see a doctor right away.
The Gateway Assessment will identify longer term health issues which will be addressed in the child or young person's plan.
If you are unsure or would like assistance:
- talk to your supervisor
- call the Health Line 0800 61 11 16 (available 24 hours every day).
If the decision tree suggests the child or young person needs to see a doctor, take the child or young person to (in order of preference):
- the general practitioner who they usually see, or with whom they are registered
- local general practitioner (if you have prior arrangements in place with the medical centre)
- local accident and medical centre
- Local public hospital emergency department.
Always ring ahead and explain to the triage nurse what your concerns are. This will make sure the appropriate doctor or nurse is available and will help reduce the waiting time.
The Initial Health Check template (DOC 57 KB) will assist the doctor in his/her examination of the child and report for Oranga Tamariki.
Conditions that require urgent medical care
- Any trouble breathing, especially while resting
- Particularly high temperature and/or hot to the touch
- Cool clammy legs and arms
- A rapid pulse
- Yellow colour to the skin or eyes (jaundice).
Diarrhoea and vomiting – especially if you are aware that there is:
- Dehydration (dry mouth, reduced urine output)
- Severe stomach pain
- Throwing up for more than 12 hours or throwing up blood
- Blood or mucous in the faeces (poos).
Brain and nerve conditions - where the child appears unwell and is/has:
- Extremely sleepy or very hard to wake up
- A terrible headache
- A stiff neck
- Complaining of blurred vision
- Loss of control of the arm, leg, or other part of the body
- Unable to walk or move normally.
Suspected fractures or broken bones
- Bone is tender, swollen and unable to bear weight.
Cuts and lacerations
- Wounds to the skin, particularly if bleeding.
Infections such as:
- Earache or any discharge from the ear
- Mucky or discharging eye
- Pus from a cut or scrape
- Painful boils
- Painful urination (peeing)
- Lice – particularly with skin irritation or bleeding
- Particularly for long term conditions such as diabetes, asthma, epilepsy
- Medication that has recently been prescribed.
Age specific concerns
Newborn to one month
Babies under one month of age are very fragile. They can get very sick very quickly. If the baby has any of the following, they should be taken to see the doctor:
- Fever or high temperature
- Uncontrollable crying which cannot be settled
- Loss of interest in eating normally
- Vomiting that continues for more than 4 hours
- Bowel movements - more than 8 times a day especially if profuse
- Belly button (umbilicus) that is red or angry
- Mucky eye or eye discharge
- White patches on the tongue and inside the mouth
- Rash to the body.
One month to one year
- Fever or high temperature
- Feels limp and is not feeding properly
- Refusal to eat at multiple feedings
- Extreme irritability
- Extreme drowsiness.