Severe Illness Getting Noticed Sooner (SIGNS)
- Topics
- Patient safety
- Health Equity
- Value-based care
- Audience
Person with lived/living experience
Point of care provider
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If you notice any of these SIGNS seek medical attention immediately.
SIGNS helps parents and caregivers recognize signs of serious illness. Developed by a team of experts, including parents and healthcare professionals, it equips you to identify and understand crucial signs that indicate your child might be seriously sick.
Additional languages
The SIGNS resource is available in the following languages:
Simplified Chinese (Mandarin)
Traditional Chinese (Cantonese)
Cree (Plains dialect)
This resource is provided “as is” and is for informational and educational purposes only. It is not intended to provide specific medical advice or replace the judgment of a healthcare professional.
What to look for
Not reacting, not moving, not responding to things such as:
Loud noise
Touch
Being talked to
Food or drink
No eye contact which can include:
Not watching moving objects
Staring
Looking blank
Unable to stay awake
Unusual movements, clumsy, slurred speech:
Seizure: repeated jerky movements of arms, legs, lips, or eyes
Floppy: limp body, arms or legs
Spasm: stiff body, arms or legs
Speech: jumbled or unclear
Difficult breathing which could include:
With each breath ribcage sucks in or neck or belly pulls in
Breathing is... noisy when resting and/or very fast
Difficult to speak
Child says it’s hard to breathe
Is out of breath
Cannot drink
Long pauses between breaths
>20 seconds between breaths
Rubbing or shouting needed so they take a breath
Gasping breath after a pause
Not peeing
No wet diapers
Not nursing or drinking
Throwing up every hour for more than 4 hours
Red or very dark/black vomit
Green or brown vomit and belly that is bigger than normal
Red blood
Medium amount (streaks) that keeps happening or large amount (blobs or more)
New skin tone or colour which can include:
Blue lips/tongue with crying, feeding or at rest
Purple blotches or many small purple dots
Gray/very pale/cold/blotchy
Cold/clammy hands or feet
Yellow skin and eyes
Sleepy
Not feeding
If a known long-term health issue is not getting better with things that usually help and any SIGNS are present: seek medical attention immediately.
These conditions include asthma, seizure disorders, diabetes and many others.
Who developed this resource?
An expert panel consisting of parents and multi-disciplinary providers created the Severe Illness Getting Noticed Sooner (SIGNS)-for-Kids as a public health tool to help parents and caregivers identify and articulate the manifestations of severe illness in children.
We would like to acknowledge the contributions of the expert panel members of the SIGNS for Kids Consortium:
Christopher Parshuram MB.ChB, D.Phil., Kristen Middaugh RN, BScN, Dawn Hartfield BSc Med, MPH, MD, FRCPC , Joelle Fawcett-Arsenault PHEc (parent representative), Melissa Jones BA MA (parent representative), Gregory Moore MD, MSt (c), FRCPC, Karen Dryden-Palmer MSN, RN, Simran Singh RN, BScN, ENC, Ann Bayliss MD, FRCPC, David Bayfield MD,CCFP(EM), Sean Murray MD, FRCPC, Jonathan Gilleland MD, FRCPC , Martin McNamara MD, CCFP (EM), Michelle Gordon MD, FRCPC, Lisa Ladouceur PHC-NP, Anthony lacolucci HonBSc RRT, Jane Stuart-Minaret RN, BScN, MN, Mohamed Eltorki MD, Angelo Mikrogianakis MD. Msc, Tania Principi MD, Seth Gray MD, Pragash Loganathan MD, Hilary Whyte MB.BCh. BAO. MSc. FRCPI. FRCPC, Helena Frndova Dipl-Ing, Zoe Parshuram BSc (Hons).
Use or reproduction of this resource is permitted within Canada for non-commercial purposes only. This resource is provided “as is” and is for informational/educational purposes only. It is not intended to provide specific medical advice or replace the judgment of a healthcare professional. Those preparing and/or contributing to this publication disclaim all liability or warranty of any kind, whether express or implied.
This work was supported by Healthcare Excellence Canada (HEC). HEC is an independent, not-for-profit charity funded primarily by Health Canada; the views expressed herein do not necessarily represent those of Health Canada.
Resources for Healthcare Providers and Leaders
Access free digital resources to promote the SIGNS resource to Spot Severe Illness in Infants, Children & Adolescents at your organization and on social media.
SIGNS Free Digital Downloads
Download a variety of images to use on social media, your website, through email, at your school, community setting, health and care facility.
Printable Posters
Downloadable Images
Related programs
Patient Safety Essentials
Enroll for freeA free, six module, self-directed program designed especially for healthcare providers to help you understand the core of patient safety.
TeamSTEPPS Canada Essentials Course
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