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Fever, Pediatric, Emergency Medicine

Nathan W. Mick and David A. Peak Reviewed 06/2017
 


Basics

Description

  • Fever is defined as a temperature of 38°C (100.4°F) rectally:

    • Oral and tympanic temperatures are generally 0.6°C–1°C lower.

  • Tympanic temperatures are not accurate in children younger t...

Diagnosis

Signs and Symptoms

  • Clinical appearance must be evaluated. Airway, breathing, and circulation (especially dehydration with impaired perfusion/color) need specific evaluation.

  • Toxicity associate...

Treatment

Pre-Hospital

  • Resuscitate as appropriate.

  • Begin cooling with antipyretics.

Initial Stabilization/Therapy

  • Treat any life-threatening conditions.

  • Antipyretic therapy

  • Evaporative cooling techniques, s...

Follow-Up

Disposition

Admission Criteria

  • All toxic patients

  • Infants 0–28 days of age with temperature >38°C

  • Nontoxic infants 29–90 days of age with temperature >38°C who do not meet low-risk criteri...

Pearls and Pitfalls

  • Fever is the most common presenting complaint in children. It may reflect a life-threatening condition.

  • Children under 28 days of age are generally treated empirically, pending cult...

Additional Reading

  • American Academy of Pediatrics. Red Book 2012: Report of the Committee on Infectious Diseases. 29th ed. Elk Grove, IL: AAP; 2012.

  • Baraff  LJ. Management of fever without source in ...

Codes

ICD9

  • 780.60 Fever, unspecified

  • 780.61 Fever presenting with conditions classified elsewhere

ICD10

  • R50.9 Fever, unspecified

  • R50.81 Fever presenting with conditions classified elsewhere

SNOMED

  • 386661006 ...

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