A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)

Abstract

BackgroundAlthough body temperature is one of four key vital signs routinely monitored and treated in clinical practice, relatively little is known about the symptoms associated with febrile states. The purpose of this study was to assess the validity, reliability and feasibility of the Fever Assessment Tool (FAST) in an acute care research setting.MethodsQualitative: To assess content validity and finalize the FAST instrument, 12 adults from an inpatient medical-surgical unit at the National Institutes of Health (NIH) Clinical Center participated in cognitive interviews within approximately 12 h of a febrile state (tympanic temperature ≥ 38° Celsius). Quantitative: To test reliability, validity and feasibility, 56 new adult inpatients completed the 21-item FAST.ResultsThe cognitive interviews clarified and validated the content of the final 21-item FAST. Fifty-six patients completed the FAST from two to 133 times during routine vital sign assessment, yielding 1,699 temperature time points. Thirty-four percent of the patients (N = 19) experienced fever at one or more time points, with a total of 125 febrile time points. Kuder-Richardson 20 (KR-20) reliability of the FAST was 0.70. Four nonspecific symptom categories, Tired or Run-Down (12), Sleepy (13), Weak or Lacking Energy (11), and Thirsty (9) were among the most frequently reported symptoms in all participants. Using Generalized Estimating Equations (GEE), the odds of reporting eight symptoms, Warm (4), Sweating (5), Thirsty (9), General Body Aches (10), Weak or Lacking Energy (11), Tired or Run Down (12) and Difficulty Breathing (17), were increased when patients had a fever (Fever Now), compared to the two other subgroups—patients who had a fever, but not at that particular time point, (Fever Not Now) and patients who never had a fever (Fever Never). Many, but not all, of the comparisons were significant in both groups.ConclusionResults suggest the FAST is reliable, valid and easy to administer. In addition to symptoms usually associated with fever (e.g. feeling warm), symptoms such as Difficulty Breathing (17) were identified with fever. Further study in a larger, more diverse patient population is warranted.Trial RegistrationClinical Trials Number: NCT01287143 (January 2011)

Ethnobotanical Survey on Plants Used to Manage Febrile Illnesses among Herbalists in Casablanca, Morocco

“…Chronic or persistent fevers (lasting > 2 weeks) are typical of chronic bacterial infections such as tuberculosis, viral infections such as HIV, cancers, and connective tissue diseases [8]. Equivalent rectal temperatures of ≥38 • C (100.4 • F) or axillary temperatures of ≥37.5 • C (99.5 • F) in both adults and children are indicative of fever [9], following to the World Health Organization (WHO) [10], the Infectious Disease Society of America [11], and the Society of Critical Care Medicine [12] recommendations, and represents one of the most common symptoms of disease in Morocco [13].…”

Antipyretic activity of aqueous extracts of Andrographispaniculata and Carica papaya in Wistar albino rats – A comparative study

“…Fever due to infection, injury, inflammation, cancer etc., is caused by generation of pyrogens such as ILs, interferons, TNFα which increases the PGE2 levels in hypothalamus and raise the temperature set point 11 . As such fever is an important sign for the health care providers, as it alerts them to intervene in preventing mortality 12 . The majority of antipyretic drugs work by inhibiting the COX enzyme involved in prostaglandin synthesis and thereby reduce the PG levels.…”

Pemanfaatan Tumbuhan Cep-cepan (Castanopsis costata) Sebagai Terapi Adjuvan Demam Di Madrasah Ibtidaiyah Al Istianah Karawang

“…Jaringan yang terinfeksi atau rusak menghasilkan mediator inflamasi yang berbeda-beda, sehingga meningkatkan sintesis prostaglandin E2 (PGE2) di hipotalamus yang menyebabkan kenaikan suhu tubuh [1]. Demam biasanya disertai dengan ketidaknyamanan seperti nyeri (mialgia), lesu, anoreksia, ketidakmampuan untuk berkonsentrasi, peningkatan tonus otot dan menggigil [2]. Hampir semua obat antipiretik saat ini memblokir sintesis PGE2 melalui penghambatan enzim siklooksigenase-2 (COX-2).…”