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The Burden Of Visits For Fever At A Paediatric Emergency Room: A Retrospective Study On Patients Presenting At The
1Department of Paediatrics, Cantons Hospital of Fribourg, Fribourg, Switzerland.
Insights
Febrile children visiting the emergency department (ED) often have lower urgency symptoms. Most febrile pediatric patients presenting to the ED do not require hospitalization, suggesting many visits could be managed in primary care settings.
Area of Science:
- Pediatrics
- Emergency Medicine
- Public Health
Background:
- Fever is a common reason for pediatric visits, accounting for up to one-third of all consultations.
- High emergency department (ED) attendance for fever prompted an investigation into patient urgency and characteristics.
Purpose of the Study:
- To analyze the characteristics of febrile pediatric patients presenting to the ED.
- To determine if these patients represent lower-urgency cases potentially suitable for primary care.
Main Methods:
- Retrospective analysis of patients aged 3 months to 5 years with a body temperature of 38.5°C or higher.
- Data collected during the 6 winter months of 2011-2012.
Main Results:
- 24% of all consultations were for febrile children.
- None of the 835 patients required hospitalization; 95% had accompanying respiratory or gastrointestinal symptoms.
- 17.6% needed respiratory support, and 36.7% received antibiotics. 56.2% sought care outside normal working hours.
Conclusions:
- Most febrile pediatric patients presenting to the ED have symptoms that warrant consultation.
- However, the majority do not require ED infrastructure, indicating potential for primary care management.
- Extended ED hours may contribute to increased visits for non-urgent febrile conditions.
Introduction:
Fever is the chief complaint of up to one-third of all paediatric office visits in many places. The high number of consultations at our emergency department (ED) led us to hypothesise that this increase was due to febrile paediatric patients with lower urgency seeking medical advice.
Methods:
We retrospectively analysed the number and characteristics of patients 3 months to 5 years of age consulting for a body temperature of 38.5°C or higher during the 6 winter months of 2011-2012.
Results:
Twenty-four percent of all consultations were requested by the patients included in our group. None of the 835 patients had to be hospitalised, 95% of these patients had additional respiratory or gastrointestinal symptoms, 36.7% required antibiotic therapy, and 17.6% (laryngitis and lower respiratory tract infection (RTI)) required temporary respiratory support. A total of 56.2% of patients sought advice outside of the normal working hours.
Conclusion:
The majority of patients had fever accompanied by additional symptoms justifying a medical consultation. However, most of these did not require the infrastructure of an ED for their health care problem and probably visited the ED because of the open hours.
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