It can be difficult to know when to send small babies to the emergency department (ED), we do not want to place them at risk of infection by attending the ED with other unwell children. However we must also balance this risk with the difficulties of detecting serious underlying infection in babies <3 months old.
Remedy and NICE guidelines suggest:
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- In infants <4 weeks measure body temperature with an electronic thermometer in the axilla. An infra-red tympanic thermometer can be used in children >4 weeks.
- In infants under 3 months: Any fever of ≥38°C requires referral to Children's ED. The only exceptions are clinically well infants who have developed a temperature within 12 hours of vaccinations (not the rota virus vaccine). If you are unsure whether to see a baby at base or to send to ED please discuss with the CC or Children's ED(0117 3428666).
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- Take any parental report of fever seriously, even if not measured by a medical professional.
- When a child has been given antipyretics, do not rely on a decrease or lack of decrease in temperature to differentiate severity of illness.
- Beware that classic signs of sepsis or meningitis are often absent in infants with bacterial meningitis.
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Feverish illness in children
This is a common urgent care presentation. Please also see guidance on sepsis in children HERE
Assessment and management of these children is outlined in NICE guidance and NICE traffic light tool. In all children take any parental report of fever seriously, even if not measured by a medical professional, never use a reduction in temperature after antipyretics to differentiate between serious and non- serious illness.
Please also review our Tips and Tripwires:
Tips and Tripwires in Urgent Paediatric Primary Care – BrisDoc Clinical ToolKit
RCPCH endorsed parent information on managing fever & safety-netting: