EM Basic- Febrile Infants [PDF]

Chest x-ray. LP- cell count, glucose and protein, gram stain, culture. PEARL- even if obvious UTI or pneumonia, still ne

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EM Basic- Febrile Infants (This document doesn’t reflect the views or opinions of the Department of Defense, the US Army or the SAUSHEC EM residency, © 2011 EM Basic, Steve Carroll DO. May freely distribute with proper attribution)

Triage note- fever at home?, exact age of patient, temp >100.4 is a fever, parental concerns, wet diapers in past 24 hours (at least 3 indicate good hydration, vomiting?, fussiness?, how are they feeding Pediatric Assessment Triangle- ABC- can be done from foot of the bed Appearance- Active vs. lethargic, good muscle tone vs. poor tone Work of Breathing- comfortable breathing vs. working hard to breathe Color- Pink vs. mottled, cyanosis, pallor If any one of these is abnormal, it demands immediate intervention Temperature- under 28 days fever is rectal temp 100.4 F or 38 C PEARL- most guidelines give same weight to a tactile fever by parents Bundling with clothes does not significantly affect rectal temperature Birth history- premature? Gestational age at birth, any birth complications? Vaccines up to date (2, 4, 6 months old), Growing or developing normally? Maternal STD history or GBS positive? (antibiotics during labor?) Physical exam- beyond the pediatric assessment triangle- low yield in patients

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