Fever, sepsis, dehydration Flashcards
What is the red flag fever temperature for babies under 3 months
> 38C
What is the red flag fever temperature for babies 3-6 months
> 39C
What tests are routinely done in children presenting with fever
" FBC " CRP " Blood culture " Urine dipstick " +/- CXR " +/- lumbar puncture
Define simple febrile convulsions
generalised tonic-clonic,
lasting LESS than 15 minutes.
Does NOT re-occur within 24 hours.
Define complex febrile convulsions
can be partial (focal),
lasts MORE than 15 minutes, re-occurs within 24 hours.
Age range in which febrile convulsions usually occur
6 months - 6 years
Percentage chance of reoccurence after first febrile seizure
30%
Risk factors for having febrile seizures
- under 18months old
- family history
What conditions would you call the ambulance for if a child is having febrile seizures
o Seizure lasts longer than 5 minutes o It is child's first seizure. o Another seizure starts soon afterwards o The child has difficulty breathing o Conscious level not fully regained one hour after seizure o Concern serious illness eg meningitis.
Questions to ask in a fever history
- How long has child had fever
- Exact temperature
- Did they give anti-pyretics, did it help
- Changes to behaviour (play, drowsy, different cry)
- Change in urinary habit
- Change in eating and drinking
- Do feet and hands feel warm or cold
- Rash
- Immunisations, if up to date
- History of travel, contact with sick person
Red flags for sepsis
" Mottled, blue or pale skin " Very lethargic, difficult to wake " Abnormally cold to touch " Breathing very fast " Non-fading rash " Fit/ convulsion
Management of sepsis
o High flow oxygen
o IV/IO access-take bloods
o IV/IO antibiotics: IV ceftriaxone or under 3 months IV cefotaxime and IV amoxicillin(against listeria).
o Fluid resuscitation: 20mls/kg
Red flags for sepsis
" Mottled, blue or pale skin " Very lethargic, difficult to wake " Abnormally cold to touch " Breathing very fast " Non-fading rash " Fit/ convulsion
Management of sepsis
o High flow oxygen
o IV/IO access-take bloods
o IV/IO antibiotics: IV ceftriaxone or under 3 months IV cefotaxime and IV amoxicillin(against listeria).
o Fluid resuscitation: 20mls/kg
Link between febrile seizures and epilepsy
NOT epilepsy.
Slight increased risk of epilepsy if had febrile seizures (2.4% compared to 1.4% in general population)
