{"id":1734,"date":"2017-08-18T06:26:57","date_gmt":"2017-08-18T06:26:56","guid":{"rendered":"http:\/\/papergp.com\/index.php\/paediatrics\/feverish-child\/"},"modified":"2019-02-18T18:06:53","modified_gmt":"2019-02-18T18:06:53","slug":"feverish-child","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/others\/genetics\/feverish-child\/","title":{"rendered":"Feverish child"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Paediatric vital signs<\/h4>\n<p>General well child:<\/p>\n<table style=\"border-collapse: collapse; width: 99.8485%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 35.4545%;\"><strong>Age<\/strong><\/td>\n<td style=\"width: 31.0606%;\"><strong>RR<\/strong><\/td>\n<td style=\"width: 33.3333%;\"><strong>HR<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.4545%;\">0-3 months<\/td>\n<td style=\"width: 31.0606%;\">30-60<\/td>\n<td style=\"width: 33.3333%;\">110-160<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.4545%;\">3-12 months<\/td>\n<td style=\"width: 31.0606%;\">25-50<\/td>\n<td style=\"width: 33.3333%;\">100-150<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.4545%;\">1-4 years<\/td>\n<td style=\"width: 31.0606%;\">20-40<\/td>\n<td style=\"width: 33.3333%;\">90-120<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.4545%;\">4-12 years<\/td>\n<td style=\"width: 31.0606%;\">20-30<\/td>\n<td style=\"width: 33.3333%;\">70-110<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 35.4545%;\">&gt;12 years<\/td>\n<td style=\"width: 31.0606%;\">12-16<\/td>\n<td style=\"width: 33.3333%;\">60-100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Advanced Paediatric Life Support criteria:<\/p>\n<table style=\"border-collapse: collapse;\" border=\"1\">\n<tbody>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\"><strong>Age<\/strong><\/td>\n<td style=\"width: 47.7273%; height: 28px;\"><strong>Heart rate (bpm)<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\">&lt; 12 months<\/td>\n<td style=\"width: 47.7273%; height: 28px;\">&lt; 160<\/td>\n<\/tr>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\">12-24 months<\/td>\n<td style=\"width: 47.7273%; height: 28px;\">&lt; 150<\/td>\n<\/tr>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\">2-5 years<\/td>\n<td style=\"width: 47.7273%; height: 28px;\">&lt; 140<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table style=\"border-collapse: collapse; width: 99.8485%;\" border=\"1\">\n<tbody>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\"><strong>Age<\/strong><\/td>\n<td style=\"width: 47.7273%; height: 28px;\"><strong>Respiratory Rate<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\">0-5 months<\/td>\n<td style=\"width: 47.7273%; height: 28px;\">&lt; 60<\/td>\n<\/tr>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\">6-12 months<\/td>\n<td style=\"width: 47.7273%; height: 28px;\">&lt; 50<\/td>\n<\/tr>\n<tr style=\"height: 28px;\">\n<td style=\"width: 52.1212%; height: 28px;\">&gt; 12 months<\/td>\n<td style=\"width: 47.7273%; height: 28px;\">&lt; 40<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Specific illness<\/h4>\n<ul>\n<li>Meningococcal disease\n<ul>\n<li>Non blanching rash, ill looking, purpura, CRT &gt; 3s, neck stiffness, bulging fontanelle<\/li>\n<\/ul>\n<\/li>\n<li>Herpes simplex encephalitis\n<ul>\n<li>Focal neurological signs, focal seizures, reduced GCS<\/li>\n<\/ul>\n<\/li>\n<li>Pneumonia\n<ul>\n<li>Tachypnoea, nasal flaring, chest indrawing, cyanosis, crackles in chest, abdo\/chest pain<\/li>\n<\/ul>\n<\/li>\n<li>UTI (presentation depends on age)\n<ul>\n<li>fever alone if under 3 months<\/li>\n<li>Vomiting, reduced feeding, lethargy, abdominal pain, urinary frequency, dysuria<\/li>\n<\/ul>\n<\/li>\n<li>Septic arthritis\n<ul>\n<li>Swelling of limb or joint, not using limb<\/li>\n<\/ul>\n<\/li>\n<li>Kawasaki disease\n<ul>\n<li>Fever &gt;5d<\/li>\n<li>Bilateral conjunctivitis<\/li>\n<li>Mucous membranes &#8211; red throat, dry cracked lips, strawberry tongue<\/li>\n<li>Extremities &#8211; oedema, erythema, desquamation polymorphous rash, cervical lymphadenopathy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211; drowsy, &lt;3 months + temp 38c, neck stiffness<\/li>\n<li>Others &#8211; E+D, PU, BO, rashes, travel<\/li>\n<li>Examine\n<ul>\n<li>General: Colour, activity<\/li>\n<li>Observations: Temperature, sats, RR, HR<\/li>\n<li>Dehydration: CRT, mucous membranes, cool extremities<\/li>\n<li>Other: Fontanelle<\/li>\n<li>Systems: chest\/CVS\/abdo\/ENT<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations<\/li>\n<li>Treatment\n<ul>\n<li>Advice for home care\n<ul>\n<li>Regular fluids<\/li>\n<li>Signs of dehydration<\/li>\n<li>Identify a non-blanching rash<\/li>\n<li>Check on child during night<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Follow-up \/ Safety-net\n<ul>\n<li>Fever &gt; 5 days<\/li>\n<li>Child looks less well after review or carer is more worried since last review<\/li>\n<li>Difficulties breathing<\/li>\n<li>Non blanching rash<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Lower respiratory tract infection in children<\/h4>\n<ul>\n<li>First line: Amoxicillin (Clarithromycin for penicillin allergy)<\/li>\n<li>Consider adding Flucloxacillin for 14-21 days for suspected infection with staphylococci (in influenza or measles)<\/li>\n<li>Consider adding a macrolide if no response after 48 hours<\/li>\n<li>Consider mycoplasma if symptoms worse than signs suggest &#8211; add macrolide and continue both agents for 10 days<\/li>\n<\/ul>\n<\/div>\n<p><a href=\"https:\/\/www.nice.org.uk\/guidance\/cg160\/resources\/support-for-education-and-learning-educational-resource-traffic-light-table-189985789\">https:\/\/www.nice.org.uk\/guidance\/cg160\/resources\/support-for-education-and-learning-educational-resource-traffic-light-table-189985789<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Paediatric vital signs General well child: Age RR HR 0-3 months 30-60 110-160 3-12 months 25-50 100-150 1-4 years 20-40 90-120 4-12 years 20-30 70-110 &gt;12 years 12-16 60-100 Advanced Paediatric Life Support criteria: Age Heart rate (bpm) &lt; 12 months &lt; 160 12-24 months &lt; 150 2-5 years &lt; 140 &nbsp; Age Respiratory Rate &hellip; <a href=\"https:\/\/papergp.com\/index.php\/others\/genetics\/feverish-child\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Feverish child<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":43,"menu_order":14,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1734","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1734","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1734"}],"version-history":[{"count":5,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1734\/revisions"}],"predecessor-version":[{"id":2192,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1734\/revisions\/2192"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/43"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1734"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}