Approach to a Febrile Child
Assessment
Features on history:
Features on examination:
NOTE: Teething will not cause fever of >38.5oC
Investigations
Features on history:
- Localising symptoms: cough, coryza, headache, photophobia, diarrhoea, vomiting, abdominal pain, joint symptoms
- Travel history
- Sick contacts
- Immunisation hx
Features on examination:
- General aspects of the child's behaviour and appearance provide the best indication of whether a serious infection is likely - Screening tool for young children presenting with acute febrile illness.
- Well or unwell
- Signs suggestive of an unwell child: lethargic, poor interaction, inconsolability, tachycardia, tachypnoea, cyanosis, poor peripheral perfusion
- Localising signs: Ear, nose and throat examination, neck stiffness, work of breathing, abdominal signs, skin rash, joint swelling
NOTE: Teething will not cause fever of >38.5oC
Investigations
Management
Any febrile child who appears seriously unwell should be investigated and admitted, irrespective of the degree of fever
When to admit/consult local paediatric team
Source
www.rch.org.au 2014
Any febrile child who appears seriously unwell should be investigated and admitted, irrespective of the degree of fever
When to admit/consult local paediatric team
- Unwell child
- Septic shock
- High-risk patients - immunosuppressed, chronic lung disease, congenital heart disease
- Advice needed regarding empirical treatment
Source
www.rch.org.au 2014