Feverish Child Flashcards
What are the amber (intermediate risk) signs for a feverish child in the child’s activity?
- Not responding normally to social cues
- No smile
- Wakes only with prolonged stimulation
- Decreased activity
What are the amber (intermediate risk) signs for a feverish child in the child’s respiration?
- Nasal flaring
- Tachypnoea (as per age range)
- Sats <95% on room air
- Crackles in the chest
What are the amber (intermediate risk) signs for a feverish child in the child’s circulation and hydration?
- Tachycardia (as per age range)
- CRT >3 seconds
- Dry mucous membranes
- Poor feeding in infants
- Reduced urine output
What are the amber (intermediate risk) signs for a feverish child in the child’s other features? (not colour, activity, respiration, circulation, or hydration)
- Age 3-6 months, temperature >39
- Fever for >5 days
- Rigors
- Swelling of limb or joint
- Non weight bearing limb or not using an extremity
What is the amber (intermediate risk) sign for a feverish child in the child’s colour (skin, lips, tongue)?
Pallor reported by parent/carer
What are the red (high risk) signs for a feverish child in the child’s colour (skin, lips, tongue)?
Pale, mottled, ashen, blue
What are the red (high risk) signs for a feverish child in the child’s activity?
- No response to social cues
- Appears ill to a healthcare professional
- Does not wake or if roused does not stay awake
- Weak, high-pitched or continuous cry
What are the red (high risk) signs for a feverish child in the child’s respiration?
- Grunting
- Tachypnoea >60
- Moderate/severe chest indrawing
What is the red (high risk) sign for a feverish child in the child’s circulation and hydration?
Reduced skin turgor
What are the red (high risk) signs for a feverish child in the child’s other features? (not colour, activity, respiration, circulation, or hydration)
- Age <3 months, temperature >38
- Non-blanching rash
- Bulging fontanelle
- Neck stiffness
- Status epilepticus
- Focal neurological signs
- Focal seizures
How do you measure temperature in a child below 4 weeks and 5 weeks and above?
- <4 weeks - electronic thermometer in axilla
2. 5 weeks or more - axilla, chemical dot, or tympanic membrane
What are the steps for safety netting in a feverish child?
- Check on child during the night
- Offer regular drinks - if refusing seek medical help
- Look for non-blanching rash by rolling a glass over it
- If well but fever continues >5 days then go to A&E
How do you investigate a fever in children under 3 months old?
- FBC, U&Es, CRP, blood culture, urine dip, CXR, stool culture
- LP in all <1 months and 1-3 months if unwell/WCC <5 or >15
How do you investigate a fever in low risk (green) children over 3 months old?
- Urine for UTI
- No bloods or CXR
- Observe
How do you investigate a fever in intermediate risk (amber) children over 3 months old?
- Urine for UTI
- FBC, CRP, blood culture
- CXR if >39 degrees/WCC >20
- Consider LP if <1 years