{"id":1741,"date":"2017-08-21T07:01:57","date_gmt":"2017-08-21T07:01:04","guid":{"rendered":"http:\/\/papergp.com\/index.php\/paediatrics\/viral-urti-in-a-child\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"fever-in-a-child","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/paediatrics\/fever-in-a-child\/","title":{"rendered":"Fever in a child"},"content":{"rendered":"\n<div class=\"content-box-blue\">\n<h4>Paediatric vital signs<\/h4>\n<table style=\"height: 170px; width: 355px; border-color: #000000;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 117px;\"><strong>Age<\/strong><\/td>\n<td style=\"width: 108.753px;\"><strong>RR<\/strong><\/td>\n<td style=\"width: 113.247px;\"><strong>HR<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 117px;\">0-3 months<\/td>\n<td style=\"width: 108.753px;\">30-60<\/td>\n<td style=\"width: 113.247px;\">110-160<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 117px;\">3-12 months<\/td>\n<td style=\"width: 108.753px;\">25-50<\/td>\n<td style=\"width: 113.247px;\">100-150<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 117px;\">1-4 years<\/td>\n<td style=\"width: 108.753px;\">20-40<\/td>\n<td style=\"width: 113.247px;\">90-120<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 117px;\">4-12 years<\/td>\n<td style=\"width: 108.753px;\">20-30<\/td>\n<td style=\"width: 113.247px;\">70-110<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 117px;\">&gt;12 years<\/td>\n<td style=\"width: 108.753px;\">12-16<\/td>\n<td style=\"width: 113.247px;\">60-100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering &#8211; History<\/h4>\n<ul>\n<li>Red flags\n<ul>\n<li>Drowsy<\/li>\n<li>Reduced feeding (&lt;50%)<\/li>\n<li>Reduced urine output<\/li>\n<li>Long pauses in breathing<\/li>\n<li>Blue lips<\/li>\n<li>Temp &gt; 38c in a less than three month old<\/li>\n<li>Non-blanching rash<\/li>\n<li>Neck stiffness<\/li>\n<\/ul>\n<\/li>\n<li>Others\n<ul>\n<li>Vomiting<\/li>\n<li>Bowels<\/li>\n<li>Fever<\/li>\n<li>Travel<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering &#8211; Examination<\/h4>\n<ul>\n<li>Vital signs\n<ul>\n<li>Temperature | RR | HR | CRT<\/li>\n<\/ul>\n<\/li>\n<li>General\n<ul>\n<li>Alertness<\/li>\n<li>Colour<\/li>\n<li>Temperature of extremities<\/li>\n<li>Mucous membranes<\/li>\n<li>Fontanelle<\/li>\n<\/ul>\n<\/li>\n<li>Body systems\n<ul>\n<li>Chest &#8211; signs of respiratory distress (nasal flaring, tachypnoea, use of accessory muscles)<\/li>\n<li>CV<\/li>\n<li>Abdomen<\/li>\n<li>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>Treatment\n<ul>\n<li>Depends on condition<\/li>\n<\/ul>\n<\/li>\n<li>Follow-up<\/li>\n<li>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>Red flags mentioned above<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Risk factors<\/h4>\n<ul>\n<li>PMH\n<ul>\n<li>Lung\/Heart\/Neuromuscular disease<\/li>\n<li>Immunosuppressed<\/li>\n<\/ul>\n<\/li>\n<li>Age\n<ul>\n<li>&lt; 6 weeks (corrected)<\/li>\n<\/ul>\n<\/li>\n<li>Pregnancy and delivery\n<ul>\n<li>Prematurity (&lt; 35 weeks)<\/li>\n<\/ul>\n<\/li>\n<li>Re-attendance<\/li>\n<li>Parental smoking<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/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 \u2013 red throat, dry cracked lips, strawberry tongue<\/li>\n<li>Extremities \u2013 oedema, erythema, desquamation polymorphous rash, cervical lymphadenopathy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Paediatric vital signs 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 &nbsp; Data gathering &#8211; History Red flags Drowsy Reduced feeding (&lt;50%) Reduced urine output Long pauses in breathing Blue lips Temp &gt; 38c in a less than three month &hellip; <a href=\"https:\/\/papergp.com\/index.php\/paediatrics\/fever-in-a-child\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Fever in a child<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":96,"menu_order":76,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1741","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1741","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=1741"}],"version-history":[{"count":10,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1741\/revisions"}],"predecessor-version":[{"id":2462,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1741\/revisions\/2462"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/96"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1741"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}