Clinical Decision-Making Case: Febrile Infant.

Area of Science:

• Pediatric Emergency Medicine
• Neonatal Critical Care

Background:

• Fever in neonates (<28 days) signifies a high risk for serious bacterial infections (SBIs) due to immature immune systems.
• Neonatal presentation of SBIs can be subtle, necessitating a systematic approach beyond initial appearance.
• Prompt recognition and management are crucial to reduce morbidity and mortality.

Purpose of the Study:

• To reinforce foundational principles for evaluating and managing febrile neonates in an emergency department setting.
• To enhance learners' ability to recognize high-risk conditions, apply diagnostic reasoning, and initiate timely empiric therapy.
• To prepare emergency medicine residents for high-stakes oral board examinations through a clinical decision-making (CDM) case format.

Main Methods:

• A clinical decision-making (CDM) case format was employed, simulating an emergency department presentation.
• Learners were prompted to articulate history, physical exam findings, differential diagnoses, diagnostic studies, treatments, and disposition.
• Evaluation utilized standardized oral board scoring guidelines and faculty/learner feedback.

Main Results:

• Preliminary assessments indicated improved learner confidence in managing febrile neonates post-case completion.
• The case effectively focused on early recognition and appropriate escalation of care for neonatal fever.
• Learners found the CDM case format beneficial for exam preparation.

Conclusions:

• Neonatal fever is a critical condition demanding immediate and precise management.
• The case underscored the importance of early sepsis recognition, thorough evaluation, and prompt treatment.
• The CDM case format is an effective tool for enhancing knowledge and application in high-stakes scenarios.