Paediatrics OTC - Pyrexia Flashcards
Define Pyrexia. (1)
Fever
Which px are more likely to experience Pyrexia? (1)
Children
What is the normal body temperature? (1)
37 degrees (+/-1)
What is the temperature difference between rectal + underarm? (1)
Rectal = 0.5 degrees higher
Underarm = 0.5 degrees lower
What type of device is used to obtain accurate readings? (1)
Infra-red device in ear
What type of equipment isn’t recommended to use for temperature reading? (1)
Forehead thermometers
What can cause pyrexia? (1)
Bacterial/viral infections producing pyrogens resulting an increase in body temperature.
What are the typical presentations of pyrexia? (5)
Irritability
Not eating
Clingy
Cough/cold
Increased RR
What important questions are asked if there’s suspected pyrexia? (5)
Age - <3 yrs (Refer) unless for post immunisation
How is the child?
What is the general perception of the parent? (your concerns section?)
What other symptoms are present?
What are the differential diagnosis of pyrexia? (3)
URTI - self limiting and viral. Look for signs of earache indicating bacterial infections.
UTI (refer) - Asymptomatic pyrexia resulting to urinary tract scarring.
Meningitis (refer)
What are the s/s of meningitis? (3)
Photophobia
Stiff Neck
Lethargy/drowsiness
Petechial rash (non-blanching rash, rash not disappearing after glass test due to burst blood vessel inside the skin)
What are the treatment options for pyrexia? (3)
Paracetamol (from 2 months post immunisation pyrexia and 3 months for general pyrexia/pain)
Ibuprofen (3 months and >5kg)
Alt regimens of paracetamol and iburprofen or both (pyrexia)
What main counselling point is given to px presenting with pyrexia? (1)
Regular fluids to maintain hydration.
What does NICE guidelines state about the use of analgesics in pyrexia tx? (1)
Use appropriate dose of paracetamol then if appropriate switch to Ibuprofen.
Only considered alternating if distress persists or reoccurs before next dose is due.
What are the types of dosing regimens for paracetamol? (7)
120mg/5ml or 250mg/5ml (6+):
3-5 months: 2.5ml every 4-6hrs
6-23 months: 5ml every 4-6hrs
2-3 years: 7.5ml every 4-6hrs
4-5 years: 10ml every 4-6 hrs.
6-7 years: 5ml every 4-6 hrs.
8-9 years: 7.5ml every 4-6 hrs
10-11 years: 10 ml every 4-6 hrs.
Max dose of 4 in 24 hr period.
What are the types of dosing regimens for Ibuprofen? (5)
100mg/5ml:
3-5 months: 2.5ml TDS (max dose of 3 in 24 hrs)
6 months - 1 yr: 2.5ml TDS/QDS
1yr - 3 yrs: 5ml TDS
4-6 years: 7.5ml TDS
7-10 years: 10ml TDS
