Philbin Deirdre, Hall Dani
Emergency Department, Children's Health Ireland at Crumlin, Dublin, Ireland
Emergency Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
Arch Dis Child Educ Pract Ed. 2022 Dec;107(6):422-426. doi: 10.1136/archdischild-2020-321335. Epub 2021 Aug 25.
Febrile children presenting to the emergency department pose unique challenges. This article highlights the importance of identifying children at particular risk of serious bacterial infection (SBI) using risk factors, red flags and appropriate investigations. Emergency clinicians must be aware of the risk factors for SBI in febrile children, including young age, ill-appearing children and those with complex comorbidities or immunodeficiency. The presence of red flags in febrile children should immediately alert concern and prompt senior clinician review. This article also discusses the appropriate use of investigations and their role in complementing clinical assessment. When discharging children home after emergency department assessment, safety netting should be undertaken to ensure parents are aware when to seek further medical opinion. The presence of a prolonged fever of 5 days or longer should alert suspicion and usually requires further investigation.
前往急诊科就诊的发热儿童面临着独特的挑战。本文强调了利用风险因素、警示信号和适当检查来识别有严重细菌感染(SBI)特殊风险儿童的重要性。急诊临床医生必须了解发热儿童发生SBI的风险因素,包括年龄小、病情不佳的儿童以及患有复杂合并症或免疫缺陷的儿童。发热儿童出现警示信号应立即引起关注并促使上级临床医生进行复查。本文还讨论了检查的合理使用及其在补充临床评估方面的作用。在急诊科评估后让儿童出院时,应进行安全防护,以确保家长知道何时寻求进一步的医疗意见。持续发热5天或更长时间应引起怀疑,通常需要进一步检查。