Calculated decisions: Step-by-Step Approach to Febrile Infants

Emily Heikamp1

  • 1Department of Pediatrics, Dana-Farber Cancer Institute, Boston, MA.

Insights

The Step-by-Step approach helps identify febrile infants under 90 days old who have a low risk of invasive bacterial infections. This review examines its evidence and applications.

Area of Science:

  • Pediatrics
  • Infectious Diseases

Background:

  • Febrile infants under 90 days old present a diagnostic challenge.
  • Differentiating low-risk infants from those with invasive bacterial infections (IBI) is crucial.

Approach:

  • The Step-by-Step approach is a clinical guideline designed for risk stratification.
  • It utilizes specific criteria to identify infants unlikely to have IBI.

Key Points:

  • Evidence supporting the Step-by-Step approach for managing febrile infants is reviewed.
  • The approach aims to reduce unnecessary investigations and hospitalizations.
  • Accuracy and safety of the Step-by-Step method in identifying low-risk infants are discussed.

Conclusions:

  • The Step-by-Step approach offers a reliable method for assessing febrile infants.
  • Its judicious application can optimize care for young children with fever.

Related Concept Videos

Methods of reducing fever01:22

Methods of reducing fever

The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
716
Patterns of Fever01:26

Patterns of Fever

Before understanding the types and patterns of fever, it is essential to know its phases.
2.7K
Increased Body Temperature01:25

Increased Body Temperature

A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
732
Decreased Body Temperature01:29

Decreased Body Temperature

A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by...
663
Assessing Body Temperature - Temporal Artery01:19

Assessing Body Temperature - Temporal Artery

Here is a stepwise guide to assessing the body temperature at the temporal artery using a temporal artery thermometer
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.  
Step 3: Assess the patient's...
612
Assessing Body Temperature - Axilla01:14

Assessing Body Temperature - Axilla

Procedural Guide for Assessing Axillary Body Temperature using a Digital Thermometer:
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...
629