When Fever, Paracetamol? Theory and Practice in a Paediatric Outpatient Clinic

Abstract

Our study showed that the management of feverish children was globally correct in the Paediatric Emergency Department, but several improvement measures have been taken (e.g. tables of normal and abnormal ranges of temperature, recommended temperature measurement techniques, dosage regimen of antipyretic drugs, guidelines to parents), justifying the implementation of a pharmaceutical follow-up.

Managing childhood fever and pain – the comfort loop

“…Excessive concern about cerebral damage and other consequences of fever is also seen in healthcare professionals [25,30-32]. In one study, less experienced paediatricians were more likely to succumb to parental anxiety and subsequently give them inappropriate advice – in this case alternating ibuprofen and paracetamol – compared with more experienced paediatricians [33].…”

“…In 11% of the children treated, the daily dose was at a level that could cause severe toxicity [36]. In contrast, a Swiss study revealed that fever was often undertreated, especially by nurses and even more so by parents [30]. Underdosing may lead to unnecessary, repeated clinic and/or emergency room visits [36].…”

“…Erroneous beliefs and undue concern in healthcare professionals could contribute to anxiety in parents and serve to perpetuate what has been termed 'fever phobia' in parents [30,31]. Gehri et al investigated how 24 medical and nursing staff treated 114 feverish children under 5 years of age in a paediatric emergency department and compared the findings with their theoretical knowledge, evaluating how they might contribute to fever phobia in parents [30].…”

“…Gehri et al investigated how 24 medical and nursing staff treated 114 feverish children under 5 years of age in a paediatric emergency department and compared the findings with their theoretical knowledge, evaluating how they might contribute to fever phobia in parents [30]. The results showed good consistency in theoretical knowledge, but an excessive fear about cerebral damage was also shown by doctors.…”

“…The results showed good consistency in theoretical knowledge, but an excessive fear about cerebral damage was also shown by doctors. This belief likely contributes to the transmission of fever phobia to parents [30]. Another study sought to examine 88 paediatric emergency nurses' knowledge base regarding fever in children since they commonly educate parents on fever management [31].…”