Parental delay in recognising the significance of a non-blanching rash has been identified as a cause of avoidable mortality and morbidity in 15% of children with meningococcal disease.1 The ‘tumbler’ or ‘glass’ test is promoted in UK national guidelines as a way to address this problem – parents are encouraged to “press a glass tumbler firmly against the rash – if you can see the spots through the glass and they do not fade seek medical advice immediately”.2 A well-conducted survey from France reports that only 7% of parents are able to recognise a petechial rash and know about the tumbler test.3The authors conclude that public information campaigns about the significance of haemorrhagic rash and the tumbler test are needed.

Front-line clinicians who routinely deal with parents phoning for advice or bringing their child for initial assessment will recognise that the issue is not so straightforward. Personal experience suggests that the test is more widely known in the UK (perhaps due to the efforts of the charitable sector), but many parents find the test difficult to perform and interpret – urgent consultations due to false positive results from the tumbler test are not uncommon and the …