All right, welcome back to the Internet Book of Critical Care Podcast.

I'm here with Adam Thomas, and we're going to talk about the approach to nuance at fever or

RIGERS in the ICU.

You can't go, I think, 15 minutes in the ICU without talking about fever, can't

you, Josh?

So this would be good because we get to talk about a lot of nuances, as in community acquired infection, ICU acquired fever, neutropenic fever, drug fever. So all

the fun things that I think we need to consider, and it's not just always a line infection, right?

Nope. So let's start out with the groundwork, because if we don't really have a shared mental

model of what a true fever is,

I think this is all useless. I think people throw numbers around there all the time, Josh.

So let's get very specific and I know this is tough, but is it 37.5, is it 38, is it 33, is

38, 5 is it 39? What is the definition of fever?

The first thing that was kind of notable when working on this is that there's very little evidence about this topic.

There's like one review article in the past five years.

So most of this stuff is really eminence-based.

There's not at least any really high-quality evidence that I'm aware of about like, you know, exactly what the sensitivity, specificity of a particular temperature are.

That's problematic because even if someone generated that data, it might not be translatable

across different institutions because we're all measuring temperature in slightly different ways.

So this is kind of a mess.

I don't know if we're going to get really good at this, Josh, because what you just said,

I think is really important that if it's tympanic, if it's armpit, if it's oral, if it's rectalosophageal, I think it's so

variable how we measure. And more importantly, you've got a great example here. The individual to

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