Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Very useful leader which reiterates well established knowledge and
The dynamic of patients is not mentioned in this leader. This works both
ways. Many primary care doctors will see patients with tachycardia and
tachypnoea associated with pyrexia. The passage of time and a spontaneous
or induced reduction in temperature can see almost a complete resolution
of signs. Many children are inappropriately admitted because no further
assessment is undertaken to assess the dynamic. Similarly, equivocal signs
can become unequivocal if the dynamic is assessed.
Assessing the dynamic of a case is probably as important as the actual
signs in equivocal cases.