Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized...
-
Upload
jazmine-pelfrey -
Category
Documents
-
view
218 -
download
3
Transcript of Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized...
![Page 1: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/1.jpg)
Febrile Illness in Children
![Page 2: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/2.jpg)
Aims of NICE?
• Guidelines for individual conditions
• Generalized guideline for unwell child
• Patient centered
• Take on board parental concerns
![Page 3: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/3.jpg)
Guidance
Non-MedicalNon-Pediatric
MedicalPediatric Medical
![Page 4: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/4.jpg)
Priorities
• Fever detection– Risk stratify with traffic light system– <4/52 – axilla– >4/52 to 5yrs – axilla or tympanic– Forehead thermometers unreliable
![Page 5: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/5.jpg)
Priorities
• Other observations– Heart rate– Respiratory rate – Capillary refill time
• Red flag features– Assessment <2hrs by Pediatricians
![Page 6: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/6.jpg)
Non-Pediatrician
CHILD
GREEN AMBER RED
![Page 7: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/7.jpg)
Green
• Strong cry / not crying
• Content / smiles
• Awake
• Normal colour - skin, lips & tongue
• Moist mucous membranes
• Normal response socially
![Page 8: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/8.jpg)
Amber
• Wakes only with prolonged stimulation • Decreased activity • Poor feeding (infants)• Absent social responses• Dry mucous membranes • Reduced urine output • New lump larger than 2 cm • Pallor • Nasal flaring
![Page 9: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/9.jpg)
Red
• Unable to rouse / does not stay awake • Weak, high-pitched cry• pale/mottled/blue/ashen • Reduced skin turgor • Bile-stained vomiting • Chest recession• RR > 60 bpm• Grunting • Bulging fontanelle • Appears ill • <3/12 + temp ≥38°C• 3–6 months + temp ≥ 39°C
![Page 10: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/10.jpg)
CHILD(Colour)
Normal colour skin, lips and tongue
Pallor
PaleMottledAshenBlue
![Page 11: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/11.jpg)
CHILD(Activity)
Normally responsesContent/smiles
Awake or awakensNormal cry/not crying
Poor responseStimulation to wakeDecreased activity
No smile
No responseAppears ill
Unable to rouseWeak/high pitch cry
![Page 12: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/12.jpg)
CHILD(Respiratory)
Nasal flaring 6–12 months RR > 50> 12 months RR > 40
O2 Sats ≤ 95% RACrackles
Grunting RR > 60 breaths/minute Mod/severe recession
![Page 13: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/13.jpg)
CHILD(Hydration)
Normal skin Moist mucous
membranes
Dry mucous membrane
Poor feedingCRT ≥ 3 secs Reduced U/O
Reduced Skin Turgor
![Page 14: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/14.jpg)
CHILD(Other)
Fever>5/7New Lump >2cm
Swelling of a limb / joint Non-weight bearing
Not using limb
0–3/12 temp≥ 38°C 3–6/12 temp≥ 39°C Non-blanching rash
Bulging fontanelle, Neck stiffness Status epilepticus, Focal neurology
Focal seizureBile Stained Vomit
![Page 15: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/15.jpg)
![Page 16: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/16.jpg)
![Page 17: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/17.jpg)
Management
GREEN
MANAGE ATHOME
![Page 18: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/18.jpg)
Management
AMBER
SAFTEY NET
Written advice
Follow up
Hand over to OOH
![Page 19: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/19.jpg)
Management
RED
URGENTREFERRAL
Less than 2 hours
![Page 20: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/20.jpg)
Other Recommendations
• Parent education– Hydration & assessment for dehydration– Adverse signs– Observation through night– What to do in emergency
![Page 21: Febrile Illness in Children. Aims of NICE? Guidelines for individual conditions Generalized guideline for unwell child Patient centered Take on board.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9c5503460f9495b81d/html5/thumbnails/21.jpg)
Other Recommendations
• Don’t prescribe abx without source
• LRTI/suspected pneumonia ≠ CXR
• Separate UTI guidelines
• Meningococcal disease– Early abx