Paediatric Fever; Roadside to Resus

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 15 January 2024

⏱️ 58 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Fever is an incredibly effective mechanism to fight off pathogens.

Clearly, whilst many illnesses that cause a fever don’t require anything more than the body’s natural response, there are some patients in which a fever might represent a serious illness. Differentiating those serious illnesses from self-limiting presentations can be tricky at times, but can also be anxiety provoking for clinicians and parents, or carers of that child.

In children the limited communication can make the diagnostic challenge of the origin of the fever a real challenge, along with the added difficult of gaining some tests. Differentiating those with a benign disease from those with a life threatening presentation can be a daunting challenge.

The numbers of presentations to healthcare providers are staggering. Paediatric fever has been reported to represent as high as 15-25% of all presentations in primary care and emergency departments, so massive numbers. Thankfully the prevalence of serious infections in children is low and is estimated at <1% in primary care settings in industrialised countries, although it has been suggested that for ED attendances the prevalence of serious illness could be as high as 25%.

So we thought with this common but tricky presentation that it was about time we tackled the topic. We'll be running through;

A definition
Patholphysiology
Relevance of the severity of the fever
Febrile seizures
Clinical assessment
NICE guidelines
Duration of fever
Management
Antipyretics

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon, Rob & James

Transcript

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0:00.0	Welcome to the recess room podcast.
0:03.5	Five, four, three, two, one, fire.
0:12.3	So hi, and welcome back to the recess room podcast.
0:15.7	I'm Simon Lang.
0:17.1	I'm Rob Fenwick.
0:18.2	And I'm Jane Jades.
0:19.0	And welcome to the first of the roadside to recess episodes of 2024 and we're back with a pretty mammoth topic looking at pediatric fever. Absolutely happy 2024 team but I hope you're comfy because like Simon says this could be a big one. What do you think, James?
0:38.2	Well, I might have had a little glance at the notes roll,
0:40.2	and I have got my pot of coffee with me rather than just one mug.
0:43.6	So if that's any indicator, we're on to a winner.
0:46.5	Notes? I didn't realize we'd ever use any.
0:49.8	I'm freestyling, Simon. I'm freestyling. I don't know what you're on about, James. I'll have to have a little look at those at some point.
0:56.2	Before we get into the episode, though, a huge thanks to Zol Medical Corporation, who collaborate
1:01.4	with us on the podcast and make this all free and open access to you. And look out for some
1:08.2	really exciting plans and some new ventures that we've got with them in
1:12.4	2024, of which we can reveal more detail in the next few months.
1:18.7	So, without further ado, let's crack in to pediatric fever.
1:26.2	Now, as James will come onto in a bit, a fever is an incredibly effective mechanism to fight off pathogens,
1:33.4	and given its relatively heavy metabolic burden, if it's still part of a response to these pathogens
1:39.4	and hasn't been lost to evolution after all these years, then it must definitely have some benefits.
1:45.4	But clearly, whilst many illnesses that cause a fever don't require anything more than that
1:50.3	body's natural response, there are some patients in which a fever might represent a serious illness.
	...

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