NICE fever guidelines for kids
Fever is the most common presentation to Paeds ED and it can be difficult to identify a focus. This causes us (me anyway) a great deal of concern. After 10 years in paediatrics it still is the one thing weighing at the back of my mind – how to identify the child with the life-threatening bacterial infection amongst all the viral illnesses. NICE have updated their guidance in May 2013.
Often, they make it easy for us. Knowing how to recognise a sick child comes pretty early on in your paediatric experience. It’s the ones that don’t look desperately sick that are tricky. Let’s be honest, at 4am, every hot child looks miserable and sleepy. You need to have a system and the NICE guideline offers a great framework, focusing around their traffic light system.
NICE traffic light system
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Here are the points that are most useful to those of us assessing kids in ED.
Temperature measurement myths dispelled
The NICE guidance clarifies the numbers. If a <3 month old has a temp of 38 or more then that puts them into red. If a 3-6 month old has a temp of 39 or more then they are amber. But the height of the temp once over 6 months old does not correlate with the severity of the illness.
Diagnosis
Consider signs of meningitis; UTI; pneumonia; meningococcal disease; herpes simplex encephalitis. But also don’t forget about septic arthritis or osteomyelitis...
Source: Life in the Fast Lane - Category: Emergency Medicine Doctors Authors: Tessa Davis Tags: Emergency Medicine Featured Pediatrics fever Guidelines NICE NICE guidelines paediatric Source Type: blogs
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