Article Text

Download PDFPDF
Fifteen-minute consultation: The approach to the febrile child
  1. Deirdre Philbin,
  2. Dani Hall
  1. Emergency Department, Children's Health Ireland at Crumlin, Dublin, Ireland
  1. Correspondence to Dr Deirdre Philbin, Children's Health Ireland, Dublin, Ireland; deirdrephilbin{at}rcsi.ie

Abstract

Febrile children presenting to the emergency department pose unique challenges. This article highlights the importance of identifying children at particular risk of serious bacterial infection (SBI) using risk factors, red flags and appropriate investigations. Emergency clinicians must be aware of the risk factors for SBI in febrile children, including young age, ill-appearing children and those with complex comorbidities or immunodeficiency. The presence of red flags in febrile children should immediately alert concern and prompt senior clinician review. This article also discusses the appropriate use of investigations and their role in complementing clinical assessment. When discharging children home after emergency department assessment, safety netting should be undertaken to ensure parents are aware when to seek further medical opinion. The presence of a prolonged fever of 5 days or longer should alert suspicion and usually requires further investigation.

  • emergency care
  • paediatric emergency medicine
  • paediatrics
  • sepsis

Statistics from Altmetric.com

Footnotes

  • Twitter @danihalltweets

  • Contributors Both DP and DH contributed equally to the conception and design of the work, analysis and interpretation of data, and drafting and critical revision of the article for content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.