The first Wednesday of August in the UK represents an exciting time for a cohort of newly qualified junior doctors who start their medical careers. For those commencing in Paediatrics and Emergency Medicine, or starting these specialties for the first time, the prospect of managing young potentially unwell children can be daunting.
Having to assess the “febrile’ child often results in a drain of colour from even the most confident of junior doctors. This quick presentation is centred specifically around assessing the febrile child and contains a few experiential and evidence based tips. It is not a comprehensive guide to history taking or examination – please watch #Paedstips you won’t find in books , How to examine children, and look at the resources via Seeing kids is child’s play at St.Emlyn’s for further detail.
If you need a framework to start with though – go no further than Listen, Look and Locate:
I’d add two points:
1) be cautious about a history of fever even if there is none currently. I’ve seen a 3 month old who presented several times to ED: afebrile on admission, because they’d been appropriately treated by paramedics. and discharged x 2
2) If you’re worried enough to treat for meningitis, then please at least make a plan for LP