Pediatric emergency department nurses’ perspectives on fever in children

Poirier, Michael P.; Davis, P Hannah; Rey, Jean; Monroe, Kathy

doi:10.1097/00006565-200002000-00003

Cited by 56 publications

(106 citation statements)

References 11 publications

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“…This may be, at least in part, because health care providers also commonly have unrealistic fears concerning fever. 3,[18][19][20] Parents' core beliefs and motivations also undermine any attempt to decrease fever phobia. Previous research has shown that fever makes parents fear that their child might be seriously ill and suffer irreparable harm.…”

Section: Discussionmentioning

confidence: 99%

Beliefs and Expectations of Canadian Parents Who Bring Febrile Children for Medical Care

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Fever phobia is a ubiquitous problem throughout the world. As a result, fever is pharmacologically overtreated, and medical attention is frequently sought by worried parents. WHAT THIS STUDY ADDS:Most Canadian parents fear their child' s fever, resulting in aggressive surveillance and treatment. Parents expect information about fever etiology and how to care for their ill child. Few parents expect antibiotics and satisfaction with care is high. abstract OBJECTIVES: The purpose of this survey was to study the beliefs, expectations, and satisfaction of Canadian parents regarding fever and the treatment of their febrile children. METHODS:A survey was developed exploring caregiver beliefs and treatment strategies, as well as expectations and satisfaction with medical care. Some items were modeled after previous studies to allow comparison. Caregivers with febrile children were recruited from 2005 to 2007 at 3 urgent care centers and emergency departments in Edmonton, Canada: a pediatric emergency department (n = 376), an urban urgent care center (n = 227), and a suburban urgent care clinic (n = 173). RESULTS:High and rapidly rising temperature, as well as physical symptoms associated with fever, caused concern in most parents surveyed. Seventy-four percent of parents felt that the elevated temperature from fever was dangerous and 90.3% always try to treat it. Forty degrees Celsius was the most commonly sited threshold for danger. Identifying the cause (80.6%) and seriousness (87.4%) of fever were the most common stressors identified. Caregivers expected to receive information about the child' s illness and appropriate treatment. The parents most often wanted information about febrile seizures and the potential dangers of febrile illness. Only 16.7% of caregivers expected antibiotics. Nearly 92% of subjects were usually satisfied with medical care.CONCLUSIONS: Fever phobia continues to be a significant issue for Canadian parents. As a result, they treat fever aggressively and often seek medical attention. Good communication is important for medical staff caring for febrile children and typically leads to satisfied parents.

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Section: Discussionmentioning

confidence: 99%

Beliefs and Expectations of Canadian Parents Who Bring Febrile Children for Medical Care

et al. 2012

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“…7,9,24 Studies of health care workers, including physicians, have revealed that most believe that the risk of heat-related adverse outcomes is increased with temperatures above 40°C (104°F), although this belief is not justified. 5,23,[25][26][27] A child with a temperature of 40°C (104°F) attributable to a simple febrile illness is quite different from a child with a temperature of 40°C (104°F) attributable to heat stroke. Thus, extrapolating similar outcomes from these different illnesses is problematic.…”

Section: Physiology Of Fevermentioning

confidence: 99%

“…31 The most consistently identified serious concern of caregivers and health care providers is that high fevers, if left untreated, are associated with seizures, brain damage, and death. 1,25,32,33 It is argued that by creating undue concern over these presumed risks of fever, for which there is no clearly established relationship, physicians are promoting an exaggerated desire in parents to achieve normothermia by aggressively treating fever in their children.…”

Section: Treatment Goalsmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

363

313

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Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a “normal” temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.

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“…17 Their consistent and most serious concern is that untreated high fever may lead to seizures, brain damage, and even death. 18 An increase in temperature plays a pivotal role in the antiinflammatory response; antipyretics may interfere with this reaction and should be avoided unless overriding conditions exist. 19 Reducing fever to prevent febrile convulsions is ineffective and unwarranted as they are benign events in five per cent of children aged three months to five years.…”

Section: Introductionmentioning

confidence: 99%