Fever in the Pediatric Patient

Wing, Robyn; Dor, Maya R.; McQuilkin, Patricia A.

doi:10.1016/j.emc.2013.07.006

Cited by 25 publications

(19 citation statements)

References 150 publications

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“…We studied the availability of guidelines for common infections: fever, respiratory tract infections (RTI), urinary tract infections (UTI) and sepsis 14. All settings had guidelines available for fever and sepsis.…”

Section: Resultsmentioning

confidence: 99%

Diversity in the emergency care for febrile children in Europe: a questionnaire study

Borensztajn

Yeung

Hagedoorn

et al. 2019

bmjpo

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ObjectiveTo provide an overview of care in emergency departments (EDs) across Europe in order to interpret observational data and implement interventions regarding the management of febrile children.Design and settingAn electronic questionnaire was sent to the principal investigators of an ongoing study (PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management), www.perform2020.eu) in 11 European hospitals in eight countries: Austria, Germany, Greece, Latvia, the Netherlands, Slovenia, Spain and the UK.Outcome measuresThe questionnaire covered indicators in three domains: local ED quality (supervision, guideline availability, paper vs electronic health records), organisation of healthcare (primary care, immunisation), and local factors influencing or reflecting resource use (availability of point-of-care tests, admission rates).ResultsReported admission rates ranged from 4% to 51%. In six settings (Athens, Graz, Ljubljana, Riga, Rotterdam, Santiago de Compostela), the supervising ED physicians were general paediatricians, in two (Liverpool, London) these were paediatric emergency physicians, in two (Nijmegen, Newcastle) supervision could take place by either a general paediatrician or a general emergency physician, and in one (München) this could be either a general paediatrician or a paediatric emergency physician. The supervising physician was present on site in all settings during office hours and in five out of eleven settings during out-of-office hours. Guidelines for fever and sepsis were available in all settings; however, the type of guideline that was used differed. Primary care was available in all settings during office hours and in eight during out-of-office hours. There were differences in routine immunisations as well as in additional immunisations that were offered; immunisation rates varied between and within countries.ConclusionDifferences in local, regional and national aspects of care exist in the management of febrile children across Europe. This variability has to be considered when trying to interpret differences in the use of diagnostic tools, antibiotics and admission rates. Any future implementation of interventions or diagnostic tests will need to be aware of this European diversity.

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Section: Resultsmentioning

confidence: 99%

Diversity in the emergency care for febrile children in Europe: a questionnaire study

Borensztajn

Yeung

Hagedoorn

et al. 2019

bmjpo

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“…Fever is the most common reason for children to be brought to an emergency department (ED) [1][2][3], with causes ranging from self-limiting illnesses of childhood to serious bacterial infections (SBIs) that can prove fatal [3][4][5]. Vital signs can help clinicians identify children at risk of serious illness.…”

Section: Introductionmentioning

confidence: 99%

Measuring vital signs in children with fever at the emergency department: an observational study on adherence to the NICE recommendations in Europe

et al. 2020

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Vital signs can help clinicians identify children at risk of serious illness. The NICE guideline for fever in under-fives recommends a routine measurement of temperature, heart rate, capillary refill and respiratory rate in all febrile children visiting the emergency department (ED). This study aims to evaluate the measurement of paediatric vital signs in European EDs, with specific attention to adherence to this NICE guideline recommendation. In a prospective observational study, we included 4560 febrile children under 16 years from the ED of 28 hospitals in 11 European countries (2014-2016). Hospitals were academic (n = 17), teaching (n = 10) and non-teaching (n = 1) and ranged in annual paediatric ED visits from 2700 to 88,000. Fifty-four percent were male, their median age was 2.4 years (IQR 1.1-4.7). Temperature was measured most frequently (97%), followed by capillary refill (86%), heart rate (73%), saturation (56%) and respiratory rate (51%). In children under five (n = 3505), a complete measurement of the four NICE-recommended vital signs was performed in 48% of patients. Children under 1 year of age, those with an urgent triage level and with respiratory infections had a higher likelihood of undergoing complete measurements. After adjustment for these factors, variability between countries remained.

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“…Además, en la mayoría de los casos el tiempo entre el inicio de la fiebre y la consulta sanitaria es muy corto 4 . El desconocimiento, las creencias erróneas y la disparidad en su abordaje contribuyen a que los padres adopten una posición de amenaza ante la situación 5 , o fever fobia . Schmitt 6 describió el fenómeno en 1980, pero diferentes autores han comprobado que sigue siendo una entidad importante7, 8, 9.…”

Section: Introductionunclassified

Análisis de los cuidados y los conocimientos parentales sobre la fiebre en la infancia

et al. 2017

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Fever in the Pediatric Patient

Cited by 25 publications

References 150 publications

Diversity in the emergency care for febrile children in Europe: a questionnaire study

Diversity in the emergency care for febrile children in Europe: a questionnaire study

Measuring vital signs in children with fever at the emergency department: an observational study on adherence to the NICE recommendations in Europe

Análisis de los cuidados y los conocimientos parentales sobre la fiebre en la infancia

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