Lethargy indicates a serious medical condition that requires immediate medical attention. It refers to an abnormal lack of alertness and spontaneous movement beyond weakness. True signs of lethargy include a lack of interaction with the environment, decreased eye contact and focus, and an inability to follow simple commands or respond to questions. While callers may use the term lethargy to describe less severe behaviors, any report of lethargy, listlessness, or excessive sleepiness requires clarification and exploration to diagnose potential underlying issues like meningitis or sepsis.

1. Lethargy
TriageLogic Training 2015

2. LETHARGY
We often hear parents describe their child’s activity as “lethargic”.
We must be very carful when documenting the word “lethargic” as
it indicates a true emergency/EMS. See the following from Barton
Schmitt:

3. • Lethargy must be differentiated from weakness. To physicians and
nurses, lethargy is a serious, abnormal symptom usually due to a
serious illness (e.g. sepsis). Lethargy with fever is often the
earliest sign of meningitis in younger children.
• Lethargy needs to be seen IMMEDIATELY.

4. SIGNS OF TRUE LETHARGY:
• Not alert when awake
• Little spontaneous movement
• Little facial expression
• Decreased eye focus
• Cant seem to focus
• Doesn’t interact with the
parent or environment
• Decreased spontaneous talking
or babbling
• Doesn’t respond to questions
• Doesn’t follow simple
commands

5. Always Explore the Possibilities!
• Callers, however, use the term lethargy to mean many different
things.
• Complaints of lethargy, listless, sluggish, acting strange, eyes are
glassy, looks sad, or sleeping a lot always need to be explored and
clarified.