Febrile child lecture+ Study guide Flashcards
Need to know: How to approach hx, exam, assess manage febrile child:
Read:
Know common causes of fever in infants and children:
Be able to recognise a child who is seriously ill
Describe management and investigations
Part 2: Acute fever - read
Persistent fever/ serious recurrent infections:
Understanding investigations and clinical microbiolgy in children:
Give examples of acute fever?
Always consider the possibility of serious infections such as ?
Whats is kawasaki disease? Whats its importance in fevers?
What are common fever and rashes (viral that go together) - benign? Vs Serious (meningococcal)
Learning outcomes:
Urinary tract infections: Presentation, acute management and recommened follow up - Read chapter
Steril urine collection, mid stream, in out catheter, or supra-pubic collection. ( try to observe)
RCH- Guidlines- Urinary tract infections: - whats different with kids?
RCH guidelines on the febrile child:
RCH guidelines Acute meningococcal disease: Read
PLus the following:
o Acute Otitis Media
o Acute Upper Airway Obstruction
o CSF interpretation
o Gastroenteritis
o Influenza
o Kawasaki Disease
o Lumbar puncture guideline
o Meningitis-Encephalitis Guideline
o Osteomyelitis and Septic Arthritis
o Periorbital and orbital cellulitis
o Fever and Petechiae
o Pharyngitis
o Pneumonia Guideline
o Pyelonephritis Guideline
o Sepsis
o Sinusitis
o Suprapubic aspirate
o Tonsillitis
o Illness in returned traveller
o Urinary tract infection
Reading- L/O:
Paeds at glance: Rashes, infections and infestations p138
Spotting the sick child- red flags for meningococcal disease:
What are congenital acquired immunodeficienies?
What are some important causes of fever not to miss in qld?
Case example: Read:
The febrile child: Session overview:
1
What is a fever?
Define:
Outline an assessment:
History: outline assessment:
Nappies? input output, concentrated- get idea of hydration status
Hx of febrile child continued:
RCH exam findings of febrile child: Explain systematically:
Examination findings: Dr Elsa
VS, Examination (system by system), Manage:
Investigations and management: Depends on:
1) Age 2) Well/unwell 3) Underlying conditions/immunisations status:
Neonates: (< less than 28 days corrected age) What investigations should be done? Outline: Management (what septic bundle needs to be done? outline)
Investigations and management pathway - 28 days to 3 months:
Read and understand:
Investigations and management pathway RCH: For greater than 3 month old child:
Investigations and management principles in children:
Read:
RCH: General key points + investigations for a febrile child: Read
Key points from RCH:
Case 1:
Bens Case: 18 month old: From study guide: Read!!!
Case 2: Dr Isla: Lecture: Read:
CAse 3: Dr Isla lecture:
Read :
Self examination: MCQs
Read do:
Acute fever
Persistent fever and serious recurrent infections
Urinary tract infections:
Case study: Cough and fever:
QCH: Sepsis pathway: Read
Recognition, First 5 minutes, first 15 minutes, first 30mins, 60
What are toxic features?
What are risk factors for sepsis?
Intial empiric antibiotics in sepsis in children:
Triggers for escalation? Intubation?
CAse 4:
Well: but has another factor - Leukemia- known to be neutropenic:
he has febrile neutropenia: Pathway
Case 5:
What is a febrile seizure?
What ages do they occur?
Are they benign?
Simple vs complex?
Determine cause of fever!
Need to counsel family on febrile seizures and there nature:
Questions parents will ask: Regarding febrile seizure
What are risk factors for epilepsy developing in children?
