Ep 173 Febrile Infant – Risk Stratification and Workup

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 30 August 2022

⏱️ 60 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant? How do the PECARN, Step-by-Step and Aronson decision tools for identifying febrile infants at low risk for IBI and SBI? Can EM Cases incorporate all these decision tools and the upcoming Canadian Pediatric Society position statement on febrile infants recommendations into one concise algorithm? and many more...

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast.
0:05.0	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.
0:13.9	EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research and
0:21.3	education. The opinions expressed on this podcast are intended for information and education
0:24.2	purposes only and should not be used to diagnose treat or prevent any medical condition,
0:26.4	nor should they be used as a substitute for medical advice and qualified practicing physician.
0:30.3	It seems that with each passing decade, we are less and less aggressive with working up
0:36.2	the febrile infant. We used to do LPs on all infants
0:40.8	under three months of age with a fever without an obvious source. And now we select infants
0:45.4	carefully under two months of age for an LP, which we're going to talk about what that
0:50.8	exact selection is in a moment. In this segment with Dr. Brett Birstine and Dr. Gary Schubert, who you may have heard before
1:00.3	on our congenital heart disease episode, we're going to dig into the recent changes in
1:05.5	management of the febrile infant under 60 days of age and the minimum workup requirement, which infants need an LP,
1:13.9	and what biomarkers, if any, can help in decisions on management.
1:18.8	So first, welcome to EM cases, Dr. Burstein.
1:21.9	This is your first time on EM cases.
1:23.4	It is.
1:23.7	Thanks for having me.
1:24.5	Could you just tell us a little bit about your professional background?
1:27.2	Sure. I'm a clinician scientist in pediatric emergency medicine and trauma team leader at the
1:32.7	Montreal Children's Hospital and Research Institute. And my main area of interest is fever in
1:38.3	infants in the first months of life. And Dr. Joubert, it's been a while, but we're absolutely
	...

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