I assume that by your surprise you weren't aware this child was likely to be so ill. If that's the case I don't blame you. You should have been told how ill this patient was. "3 month old - dehydration" rather understated the point. Whether this is a failing of the G.P not recognising a serious illness in a child, or your control staff not conveying the message to you properly is a matter for serious discussion. I think, sadly, it could be the former. You recognised an ill child straightaway; because you know what one looks like. The question is did anyone else? Personally, I think you made the right decision.