1 - Paeds - Resp - The Febrile Child Flashcards
Most have…
brief, self limiting viral infection
how to identify fever? axillary temps different how?
<4 weeks = electronic thermometer in axilla
<5y = electronic/chemical dot thermometer in axilla or infrared tympanic thermometer
they underestimate by 0.5 C
if <3m with non specific clinical features … likely to be
likely to be bact infection unidentifiable by clinical examination (unlikely viral infection of older infants due to passive immunity from mother)
if <3m with non specific clinical features… mgmt
need urgent Ix - septic screen, and immiediate IV ABx to prevent decline/spread
febrile child - risk factors for it to be serious
illness in family/community, unimmunised, recent travel abroad, contact with animals (brucellosis), immunodeficiency
Red flags for urgent Ix/serious illness - 10 things
dehydration/shock pale/blue/mottled colour reduced GCS neck stiff bulging fontanelle status epilepticus focal neuro signs/seizures resp distress bile stained vomit >38 if <3m and >39 if 3-6m
mgmt if not seriously ill
manage at home with regular parental review, warns of signs to look for
if seriously unwell/no focus of infection
require Ix/obs/Tx - in PAU/PED, septic screen needed
what is given immediately if seriously unwell
when give aciclovir?
parenteral ABx given immediately
aciclovir if HerpeS Encephalitis suspected
3 other things to do/not do/give
supportive care
do not undress
use anti-pyretic if distressed/unwell
what is in a septic screen
blood culture FBC CRP Urine dip (Lactate)
