Fever Flashcards
Why is fever important in paeds
It is the commonest acute paediatric presentation
Most common causes - 2
URTI
Sepsis
Other causes:
- Resp
- GI
- Urinary
- ENT
- CNS
- 1 more
Resp - URTI, pneumonia, bronchoiolitis, epiglottitis
GI - gastroenteritis, appendicitis, hepatitis
Urinary – UTI and pyelonephritis
ENC – otitis media, tonsilitis, pharyngitis
CNS – meningitis
Septic arthritis
Other critical illnesses - just list a few
Shock
GI: obstruction especially volvulus
Respiratory from: asthma foreign body pneumothorax
Cardiovascular: arrythmia, acute HF from congenital heart disease
Metabolic: low glucose, BKA, inborn metabolic ARA, electrolyte imbalance
Trauma
DIC
Haemolytic uraemic syndrome
Reye’s syndrome
Red flags in paediatric critical illness
Reduced feeding less than 50% of normal daily feeding Persistent shortness of breath Continuous high-pitched moans/cries Certain skin signs: pale, mottled, cyanosed A pathetic drowsy Oliguric or hypovolaemic Bloody diarrhoea Seizures
M of a child with fever - NICE traffic light system
Green – signs, investigations, management
No symptoms except fever
Midstream urine
Homecare
M of a child with fever - NICE traffic light system
Amber - signs, investigations, management
Pallor Reduced responses or activity Respiratory distress Dehydration Fever > 5 days Capillary refill > 2seconds Joint swelling
Septic screen +/- CXR and LP
Safety nets i.e. Come back if no improvement or hospital referral
M of a child with fever - NICE traffic light system
Red - signs, investigations, management
Mottled, blue or purpuric skin. Reduced skin turgor
Non-responsive, weak or high-pitched or continuous cry
Grunting RR>16, chest recession
Over 38° and <3 months old or over 39° and <6 months old
Bulging fontanelle, stiff neck or focal neurological signs
Bilious vomit
Septic screen
U+E
Blood gas
Hospital
