Febrile Illness in Children - PowerPoint PPT Presentation

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Febrile Illness in Children

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  1. Febrile Illness in Children

  2. Aims of NICE? • Guidelines for individual conditions • Generalized guideline for unwell child • Patient centered • Take on board parental concerns

  3. Priorities • Fever detection • Risk stratify with traffic light system • <4/52 – axilla • >4/52 to 5yrs – axilla or tympanic • Forehead thermometers unreliable

  4. Priorities • Other observations • Heart rate • Respiratory rate • Capillary refill time • Red flag features • Assessment <2hrs by Pediatricians

  5. Non-Pediatrician

  6. Green • Strong cry / not crying • Content / smiles • Awake • Normal colour - skin, lips & tongue • Moist mucous membranes • Normal response socially

  7. Amber • Wakes only with prolonged stimulation • Decreased activity • Poor feeding (infants) • Absent social responses • Dry mucous membranes • Reduced urine output • New lump larger than 2 cm • Pallor • Nasal flaring

  8. Red • Unable to rouse / does not stay awake • Weak, high-pitched cry • pale/mottled/blue/ashen • Reduced skin turgor • Bile-stained vomiting • Chest recession • RR > 60 bpm • Grunting • Bulging fontanelle • Appears ill • <3/12 + temp ≥38°C • 3–6 months + temp ≥ 39°C

  9. Management GREEN MANAGE AT HOME

  10. Management AMBER Written advice SAFTEY NET Follow up Hand over to OOH

  11. Management RED URGENT REFERRAL Less than 2 hours

  12. Other Recommendations • Parent education • Hydration & assessment for dehydration • Adverse signs • Observation through night • What to do in emergency

  13. Other Recommendations • Don’t prescribe abx without source • LRTI/suspected pneumonia ≠ CXR • Separate UTI guidelines • Meningococcal disease • Early abx