Comparing different patterns for managing febrile children in the ED between emergency and pediatric physicians: impact on patient outcome

Seow, Vei-Ken; Lin, Aming Chor-Ming; Lin, I-Yin; Chen, Cien-Chih; Chen, Kuo-Chih; Wang, Tzong-Luen; Chong, Chee-Fah

doi:10.1016/j.ajem.2007.03.001

Cited by 29 publications

(15 citation statements)

References 19 publications

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“…This finding may be due to the peculiar organization of the Italian Health System: all the children are assigned to a certain paediatrician since birth, without any charge to pay for medical visits, and they will be followed very closely until 14 years of age. Other authors previously investigated knowledge and behaviours of paediatricians or nurses [12,14,[18][19][20][21][22][23]. Similarly to our results, dangerous practices as the use of alternating antipyretics, rectal administration of drugs, or the use of antipyretics for the prevention of febrile convulsions, were found to be recommended by a large share of paediatricians [23].…”

Section: Discussionsupporting

confidence: 70%

Factors Affecting Daycare Center Teachers’ Management of Childhood Fever

Park¹,

Kim²

2016

Child Health Nurs Res

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Background: Guidelines for the management of fever in children have been recently published, however "fever phobia" is still spreading. To provide information which may sustain educational interventions tailored to our population we investigated the parental and medical knowledge and management of fever in preschool children. Methods: A questionnaire was administered to a convenient sample of Italian parents and paediatricians. The questionnaire elicited information about definition and cause of fever, concerns about fever, method of temperature measurement, and treatment modalities. Results: Overall, 388 parents and 480 paediatricians were interviewed. All the parents believed that fever could cause at least one harmful effect and 89.9% (n = 349) believed that, if left untreated, it can cause brain damage or seizures. Parents used multiple resources to obtain information about fever but 67.8% (n = 264) considered paediatricians as their primary resource. Several wrong behaviours were found in the same proportions among parents and paediatricians: 78.5% of paediatricians (n = 377) and 77.8% of parents (n = 302) used physical method to reduce fever (P = 0.867); 27.0% of paediatricians (n = 103) and 21.4% (n = 83) of parents declared to alternate ibuprofen and acetaminophen (P = 0.953). Differently, 73.1% (n = 351) of paediatricians preferred oral to rectal administration of antipyretics compared to 48.7% (n = 190) of parents (P < 0.0001). Worrisomely, 1.4% of paediatricians and 1.2% of parents declared to use acetylsalicylic acid or steroids as second-choice antipyretics (P = 0.937) and 6.7% (n = 26) of parents declared to use table-or teaspoons for determining the dose of drug. Conclusions: Paediatricians' attitudes greatly influence the parental behaviours and beliefs. Implementation of educational programs regarding the management of the febrile child are needed in our setting.

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Section: Discussionsupporting

confidence: 70%

Factors Affecting Daycare Center Teachers’ Management of Childhood Fever

Park¹,

Kim²

2016

Child Health Nurs Res

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“…A number of large prospective studies have established criteria to accurately identify children warranting presumptive antibiotic therapy [9,10]. Traditional laboratory screening tests include total white blood cell count, absolute neutrophil count, band to neutrophil ratio and C-reactive protein [11-13].…”

Section: Introductionmentioning

confidence: 99%

Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

Kossiva

Soldatou

Gourgiotis³

et al. 2013

Ital J Pediatr

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BackgroundHepcidin is classified as a type II acute phase protein; its production is a component of the innate immune response to infections.ObjectiveTo evaluate the alterations of serum hepcidin in children during and following an acute febrile infection.Materials and methods22 children with fever of acute onset (< 6 hours) admitted to the 2nd Department of Pediatrics-University of Athens. Based on clinical and laboratory findings our sample formed two groups: the viral infection group (13 children) and the bacterial infection group (9 children). Hepcidin, ferritin and serum iron measurements were performed in all subjects.ResultsSerum hepcidin values did not differ notably between children with viral and bacterial infection, but a significant reduction of hepcidin was noted in both groups post-infection.ConclusionOur study provides clinical pediatric data on the role of hepcidin in the face of an acute infection. In our sample of children, hepcidin was found to rise during the acute infection and fall post-infection.

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“…There are guidelines and protocols 4,10 that are meant to become an important tool in the correct treatment of children who present with FWS, but they are not always followed. Such guidelines are often unwelcome or ignored, although their implementation is being introduced gradually in healthcare practises [22][23][24] .…”

Section: Introductionmentioning

confidence: 99%

Análisis del conocimiento y manejo de la fiebre por parte de pediatras y residentes en relación a un proceso asistencial establecido

Puga¹,

Torrecillas²,

Morillas³

et al. 2012

Rev Pediatr Aten Primaria

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ResumenAnálisis del conocimiento y manejo de la fiebre por parte de pediatras y residentes en relación a un proceso asistencial establecido Objective: to evaluate the advice given to parents about fever, determine the incidence of Fever Without Source (FWS) in the pediatrician's office, availability of complementary examinations (CE) and the implementation of fever guidelines (FG).Methods: questionnaires distributed to 151 Primary Attention Pediatricians (PAP), Hospital Pediatricians (HP) and Residents (R). Statistical analysis SPSS 15.0. For qualitative variables the χ 2 test was used. Significant value was p < 0,05.Results: 109 questionnaires analyzed: women 65,4% and men 34,6%. 44,9% defined fever 37,5 °C axilar temperature and 38 °C rectal temperature. 78,9% advise the use of electronic thermometer, 93,6% advice taking non-drug measures, 79,8% choose paracetamol and 76,1% alternate antipyretics in selected cases. 56,2% diagnosed 10% of FWS per week, 19,3% always encode it, 31,2% sometimes and 45,9% never. For infants < 6 m are required: 91,7% urine strips, 41,3% urine culture; from 6-12 months: 96,3% urine strips and 11,9% urine culture. PAP receive results the same day: CBC count 3%, radiology 68,6% and urine culture in less than 72h, 38,7%. HP and R the same day, CBC 83,3% and Rx 85,7% and urine cultures 85,7% in less than 72 hours. Infants from 1-3 months with FWS are sent to hospital by PAP 74,6% and HP 64,7% and 83,3% of residents ask for CE. 78,9% know the FG, 69,8% believe them applicable, and 65.4% apply them.Conclusions: in majority of cases it is recommended to use electronic thermometers, take non-drug measures and use paracetamol. Selected alternation of antipyretics. Underdiagnosis of FSF. Limited access to complementary exams by PAP. High awareness but low FG implementation.Objetivo: evaluar el consejo dado a padres sobre la fiebre y conocer la incidencia estimada de fiebre sin foco (FSF) en consulta, la accesibilidad a exámenes complementarios (EC) y la aplicación de un protocolo (PF).Métodos: cuestionario sobre un total de 151 pediatras de Atención Primaria (PAP), pediatras de hospital (PH) y residentes de Pediatría (R). Se utiliza el paquete estadístico SPSS ® 15.0. Para variables cualitativas el test de la χ 2 , siendo el valor significativo p < 0,05.Resultados: se han evaluado 109 cuestionarios: mujeres 65,4% y hombres 34,6%. El 44,9% definió como fiebre 37,5 °C en axila y 38 °C en recto. El 78,9% aconseja termómetro electrónico; el 93,6%, medidas físicas; el 79,8%, paracetamol, y el 76,1% alterna antitérmicos en casos seleccionados. El 56,2% diagnostica un 10% de FSF a la semana, el 19,3% codifica siempre; el 31,2% algunas veces, y el 45,9% no lo hace. En menores de seis meses, el 91,7% solicita tira de orina, y el 41,3%, urocultivo;

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Comparing different patterns for managing febrile children in the ED between emergency and pediatric physicians: impact on patient outcome

Cited by 29 publications

References 19 publications

Factors Affecting Daycare Center Teachers’ Management of Childhood Fever

Factors Affecting Daycare Center Teachers’ Management of Childhood Fever

Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

Análisis del conocimiento y manejo de la fiebre por parte de pediatras y residentes en relación a un proceso asistencial establecido

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