Pyrexia (Paediatric) Flashcards
Sequence of events and symptom analysis
Open question
Clarify- what do you mean by fever
Timeline- when did they first become unwell, what did you notice at the time, how have things progressed
Other symptoms- how are they in general, any vomiting, pain, night sweats
Systems review
Haematological- bruising, bleeding, recurrent infections, more tired than normal
RS/CVS- cough, describe it, any wheeze or strange sounds, sputum, chest pain
ENT- runny nose, sore throat, earache, discharge from ears, change in hearing
GIT- tummy ache, D and V, stools
GUT- burning pain when passing urine
NS- headache, neck stiffness, rash
Constitutional- FWARJNL (animal bites, foreign travel)
Traffic light
Pregnancy and birth history
developmental history
immunisation history
feeding history
Patients perspective
feelings and impact on life
ICE
Background
PMH- previous infections
DH
FH
SH (pets, smoking at home etc.)
URTI
general coryza
may develop earache and otitis media secondary to this
Meningitis
Unwell child, irritable drowzy
UTI
typical Sx
Bronchiolitis
common viral illness
less wet nappies, poor feeding, grunting sounds
Croup
viral illness causing barking cough stridor and coryzal symptoms
commonest in first few years of life, self-limiting, worse at night
can cause airway obstruction- take seriously
Kawasaki disease
fever 5 days+
Red pharynx, injected lips, strawberry tongue, conjunctival injection, change in extremities, polymorphous rash, cervical lymphadenopathy
Others
Tonsillitis
Otitis media
Pneumonia
Epiglottitis
SA/osteomyelitis
Investigations
bedside- physical exam, observations, urine dipstick with MCS
Bloods- FBC CRP LFT UE cultures etc. (ABG lactate- think sepsis)
Specialist- CXR, LP (if meningitis suspected, may require CT head if LP can’t be performed)
