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Be'er M, Rimon A, Segev O, Huber A, Scolnik D, Glatstein M. Incidence of Bacteremia and Serious Bacterial Infections in Hyperpyrexic Infants Offered Universal Pneumococcal Conjugate Vaccine 13 and Haemophilus influenzae B Immunization. Pediatr Emerg Care 2024; 40:e143-e146. [PMID: 38776442 DOI: 10.1097/pec.0000000000003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND High fevers, especially in young children, often alarm clinicians and prompt extensive evaluation based on perceptions of increased risk of serious bacterial infection (SBI), and even brain damage or seizure disorders. OBJECTIVE The aim of this study was to determine the prevalence of SBI in infants aged 3-36 months with fever ≥40.5°C in a population of infants offered universal pneumococcal conjugate vaccine 13 and Haemophilus influenzae B immunization. METHODS This study is a retrospective review of all infants aged 3-36 months with temperature ≥40.5°C presenting to a tertiary care pediatric emergency department over a 30-month period in an era of universal pneumococcal conjugate 13 and H. influenzae B immunization. RESULTS SBI was recorded in 54 (21.8%) of 247 study infants, most commonly pneumonia 30 patients (12.1%) and urinary tract infection 16 patients (6.5%). Two patients had positive blood cultures, yielding a bacteremia rate of 0.8%. Patients with SBI had a significantly higher WBC count ( P < 0.0001) and C-reactive protein levels ( P < 0.0001), and were significantly more likely to be hospitalized ( P < 0.0001). DISCUSSION Although SBI was common (21.8%) in our cohort of hyperpyrexic infants universally offered vaccination with pneumococcal conjugate 13 and H. influenzae B vaccines, bacteremia was a rare finding (0.8%).
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Affiliation(s)
| | | | - Or Segev
- From the Department of Pediatrics
| | | | - Dennis Scolnik
- Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada
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Çelik T, Güzel Y. Parents' Knowledge and Management of Fever: "Parents Versus Fever!". Turk Arch Pediatr 2024; 59:179-184. [PMID: 38454227 PMCID: PMC11059622 DOI: 10.5152/turkarchpediatr.2024.23152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/18/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Parents' lack of knowledge about fever causes fear and incorrect practices. This study aims to investigate the fever knowledge level, concerns, and practices of parents of preschool children. MATERIALS AND METHODS In this descriptive, cross-sectional study, conducted between July 2021 and July 2022, a survey was conducted among parents of children aged 6 months to 5 years who did not have a history of febrile seizure and/or chronic disease, either in themselves or their siblings. RESULTS A total of 386 parents, with a mean age of 33.6 ± 6.38 years and a mean number of children of 1.85 ± 0.9, participated in the study. Approximately one-third of parents started giving antipyretics to their child before the body temperature reached 38°C (32.4%) and/or used them alternately (34.5%). Moreover, approximately two-thirds (67.1%) tended to seek medical help within the first 12 hours. Parents who could not define fever correctly (66.6%) were more likely to start giving antipyretics before the child's body temperature reached 38°C [odds ratio (OR) 2.83 (1.70-4.71), P .001] and seek medical help within the first 12 hours [OR 1.81 (1.16-2.82), P = .008]. As the number of children or length of parenting increased, parents started giving antipyretics before the body temperature reached 38°C [OR 1.61 (1.26-2.06), P < .001; OR 1.04 (1.01-1.08), P = .048] and used them alternately [OR 1.07 (1.03-1.11), P = .001; OR 1.28 (1.02-1.62), P = .031]. CONCLUSION This study demonstrates that a substantial proportion of parents still cannot define fever correctly, and inappropriate antipyretic use is more prevalent among experienced parents with multiple children and/or longer lengths of parenting.
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Affiliation(s)
- Taylan Çelik
- Division of Pediatric Infectious Disease, Departmant of Pediatrics, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Yusuf Güzel
- Departmant of Pediatrics, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
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Liang CS, Forster C, Williams AE. High-Value Care During the COVID-19 Pandemic: Lessons Learned and Future Opportunities. Hosp Pediatr 2022; 12:e216-e218. [PMID: 35641475 DOI: 10.1542/hpeds.2021-006511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Cynthia S Liang
- Department of Pediatrics
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Catherine Forster
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Allison E Williams
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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Marchese AL, Fine AM, Levy JA, Monuteaux MC, Michelson KA. Physician Risk Perception and Testing Behaviors for Children With Fever. Pediatr Emerg Care 2022; 38:e805-e810. [PMID: 35100780 PMCID: PMC9340816 DOI: 10.1097/pec.0000000000002413] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Risk tolerance and risk perceptions may impact clinicians' decisions to obtain diagnostic tests. We sought to determine whether physician risk perception was associated with the decision to obtain blood or imaging tests among children who present to the emergency department with fever. METHODS We conducted a retrospective, cross-sectional study in the Boston Children's Hospital emergency department. We included children aged 6 months to 18 years from May 1, 2014 to April 30, 2019, with fever. Our primary outcome was diagnostic testing: obtaining a blood and/or imaging test. We assessed risk perception using 3 scales: the Risk Tolerance Scale (RTS), Stress From Uncertainty Scale (SUS), and Malpractice Fear Scale (MFS). A z score was assigned to each physician for each scale. Mixed-effects logistic regression assessed the association between physician risk perception and blood or imaging testing. We also examined the relationship between each risk perception scale and several secondary outcomes: blood testing, urine testing, diagnostic imaging, specialist consultation, hospitalization, and revisit within 72 hours. RESULTS The response rate was 55/56 (98%). We analyzed 12,527 encounters. Blood/imaging testing varied between physicians (median, 48%; interquartile range, 41%-53%; range, 30%-71%). Risk Tolerance Scale responses were not associated with blood/imaging testing (odds ratio [OR], 1.03 per SD of increased risk perception; 95% confidence interval [CI], 0.95-1.13). Stress From Uncertainty Scale responses were not associated with blood/imaging testing (OR, 1.04 per SD; 95% CI, 0.95-1.14). Malpractice Fear Scale responses were not associated with blood/imaging testing (OR, 1.00 per SD; 95% CI, 0.91-1.09). There was no significant association between RTS, MFS, or SUS and any secondary outcome, except that there was a weak association between SUS and specialist consultation (OR, 1.12; 95% CI, 1.00-1.24). CONCLUSIONS Across 55 pediatric emergency physicians with variable testing practices, there was no association between risk perception and blood/imaging testing in febrile children.
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Affiliation(s)
- Ashley L Marchese
- From the Division of Emergency Medicine, Boston Children's Hospital, Boston, MA
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Green C, Krafft H, Guyatt G, Martin D. Symptomatic fever management in children: A systematic review of national and international guidelines. PLoS One 2021; 16:e0245815. [PMID: 34138848 PMCID: PMC8211223 DOI: 10.1371/journal.pone.0245815] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/19/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Divergent attitudes towards fever have led to a high level of inconsistency in approaches to its management. In an attempt to overcome this, clinical practice guidelines (CPGs) for the symptomatic management of fever in children have been produced by several healthcare organizations. To date, a comprehensive assessment of the evidence level of the recommendations made in these CPGs has not been carried out. METHODS Searches were conducted on Pubmed, google scholar, pediatric society websites and guideline databases to locate CPGs from each country (with date coverage from January 1995 to September 2020). Rather than assessing overall guideline quality, the level of evidence for each recommendation was evaluated according to criteria of the Oxford Centre for Evidence-Based Medicine (OCEBM). A GRADE assessment was undertaken to assess the body of evidence related to a single question: the threshold for initiating antipyresis. Methods and results are reported according to the PRISMA statement. RESULTS 74 guidelines were retrieved. Recommendations for antipyretic threshold, type and dose; ambient temperature; dress/covering; activity; fluids; nutrition; proctoclysis; external applications; complementary/herbal recommendations; media; and age-related treatment differences all varied widely. OCEBM evidence levels for most recommendations were low (Level 3-4) or indeterminable. The GRADE assessment revealed a very low level of evidence for a threshold for antipyresis. CONCLUSION There is no recommendation on which all guidelines agree, and many are inconsistent with the evidence-this is true even for recent guidelines. The threshold question is of fundamental importance and has not yet been answered. Guidelines for the most frequent intervention (antipyresis) remain problematic.
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Affiliation(s)
- Cari Green
- Gerhard Kienle Chair, Health Department, University of Witten/Herdecke, Herdecke, Germany
| | - Hanno Krafft
- Gerhard Kienle Chair, Health Department, University of Witten/Herdecke, Herdecke, Germany
| | - Gordon Guyatt
- Departments of Health Research Methods, Evidence and Impact and Medicine at McMaster University, Hamilton, Canada
| | - David Martin
- Gerhard Kienle Chair, Health Department, University of Witten/Herdecke, Herdecke, Germany
- University Children’s Hospital, Tübingen University, Tübingen, Germany
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Brandenberger J, Bozorgmehr K, Vogt F, Tylleskär T, Ritz N. Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients. Int J Equity Health 2020; 19:58. [PMID: 32357879 PMCID: PMC7193367 DOI: 10.1186/s12939-020-01172-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background Migrant health has become an essential part of public health. According to the World Health Organization, many health systems in Europe have not yet adapted adequately to the needs of asylum-seekers, which might result in untimely and inefficient health care for asylum-seeking patients. The aim of this study was to assess the number of preventable hospital admissions and emergency department visits in asylum-seeking and non-asylum-seeking pediatric patients. Methods This is a retrospective, hospital-based study. The study was done at the University Children’s Hospital Basel in Switzerland. Patients admitted or presenting to the emergency department were included and split into the groups of asylum-seeking and non-asylum-seeking patients. All admissions and emergency-department visits were extracted from the administrative electronic health records from 1st Jan 2016-31st Dec 2017. The main outcome was the proportion of admissions due to ambulatory-care-sensitive conditions (which refer to conditions for which admission can be prevented by early interventions in primary care) in asylum-seeking and non-asylum-seeking patients. Ambulatory-care-sensitive conditions were defined by a validated list of ICD-10 codes. The secondary objective was to assess the number of preventable emergency-department visits by asylum-seeking patients defined as proportion of visits with a non-urgent triage score. Results A total of 75′199 hospital visits were included, of which 63′405 were emergency department visits and 11′794 were admissions. Ambulatory-care-sensitive conditions accounted for 12.1% (18/149) of asylum-seeking and 10.9% (1270/11645) of non-asylum seeking patients’ admissions. Among the emergency department visits by asylum-seeking patients, non-urgent conditions accounted for 82.2% (244/297). Conclusions Admissions due to ambulatory-care-sensitive conditions are comparable in asylum-seeking and non-asylum-seeking children, suggesting few delayed presentations to ambulatory care facilities. Strategies to prevent non-urgent visits at pediatric emergency department facilities are needed.
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Affiliation(s)
- Julia Brandenberger
- University of Basel Children's Hospital, Migrant Health Service, Basel, Switzerland. .,Pediatric Emergency Department, University Children's Hospital, Bern, Switzerland.
| | - Kayvan Bozorgmehr
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.,Department of Population Medicine and Health Services Research School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Florian Vogt
- Unit of NTDs, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Nicole Ritz
- University of Basel Children's Hospital, Migrant Health Service, Basel, Switzerland.,University of Basel Children's Hospital, Pediatric Infectious Disease and Vaccinology, Basel, Switzerland.,Department of Pediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia
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Piller S, Herzog D. The Burden Of Visits For Fever At A Paediatric Emergency Room: A Retrospective Study On Patients Presenting At The Cantons Hospital Of Fribourg, A Peripheral Public Hospital Of Switzerland. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2019; 10:147-152. [PMID: 31814793 PMCID: PMC6863118 DOI: 10.2147/phmt.s219759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/23/2019] [Indexed: 11/23/2022]
Abstract
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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Affiliation(s)
- Sarah Piller
- Department of Paediatrics, Cantons Hospital of Fribourg, Fribourg, Switzerland
| | - Denise Herzog
- Department of Paediatrics, Cantons Hospital of Fribourg, Fribourg, Switzerland
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Urbane UN, Likopa Z, Gardovska D, Pavare J. Beliefs, Practices and Health Care Seeking Behavior of Parents Regarding Fever in Children. ACTA ACUST UNITED AC 2019; 55:medicina55070398. [PMID: 31336677 PMCID: PMC6681325 DOI: 10.3390/medicina55070398] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 11/25/2022]
Abstract
Background and objectives: Fever in children is one of the most common reasons for seeking medical attention. Parents often have misconceptions about the effects to fever, which leads to inappropriate use of medication and nonurgent visits to emergency departments (ED). The aim of this study was to clarify the beliefs on the effects and management of fever and to identify healthcare seeking patterns among parents of febrile children in Latvia. Materials and Methods: Parents and legal guardians of children attending ED with febrile illness were included in the study. Participants were recruited in Children’s Clinical University Hospital (CCUH) in Riga, and in six regional hospitals in Latvia. Data on beliefs about fever, administration of antipyretics, healthcare-seeking behavior, and experience in communication with health care workers were collected via questionnaire. Results: In total, 355 participants were enrolled: 199 in CCUH and 156 in regional hospitals; 59.2% of participants considered fever itself as indicative of serious illness and 92.8% believed it could raise the child’s body temperature up to a dangerous level. Antipyretics were usually administered at median temperature of 38.0 °C, and the median temperature believed to be dangerous was 39.7 °C; 56.7% of parents usually contacted a doctor within the first 24 h of the illness. Parents who believed that lower temperatures are dangerous to a child were more likely to contact a doctor earlier and out-of-hours; 60.1% of participants had contacted their family doctor prior their visit to ED. Parental evaluation of satisfaction with the information and reassurance provided by the doctors at the hospital was higher than of that provided by their family doctor; 68.2% of participants felt safer when their febrile children were treated at the hospital. Conclusions: Fever itself was regarded as indicative of serious illness and potentially dangerous to the child’s life. These misconceptions lead to inappropriate administration of antipyretics and early-seeking of medical attention, even out-of-hours. Hospital environment was viewed as safer and more reassuring when dealing with febrile illness in children. More emphasis must be placed on parental education on proper management of fever, especially in primary care
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Affiliation(s)
- Urzula Nora Urbane
- Department of Pediatrics, Riga Stradins University, Vienibas gatve 45, LV-1004 Riga, Latvia.
- Department of Pediatrics, Children's Clinical University hospital, Vienibas gatve 45, LV-1004 Riga, Latvia.
| | - Zane Likopa
- Department of Pediatrics, Children's Clinical University hospital, Vienibas gatve 45, LV-1004 Riga, Latvia
| | - Dace Gardovska
- Department of Pediatrics, Riga Stradins University, Vienibas gatve 45, LV-1004 Riga, Latvia
- Department of Pediatrics, Children's Clinical University hospital, Vienibas gatve 45, LV-1004 Riga, Latvia
| | - Jana Pavare
- Department of Pediatrics, Riga Stradins University, Vienibas gatve 45, LV-1004 Riga, Latvia
- Department of Pediatrics, Children's Clinical University hospital, Vienibas gatve 45, LV-1004 Riga, Latvia
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Leigh S, Grant A, Murray N, Faragher B, Desai H, Dolan S, Cabdi N, Murray JB, Rejaei Y, Stewart S, Edwardson K, Dean J, Mehta B, Yeung S, Coenen F, Niessen LW, Carrol ED. The cost of diagnostic uncertainty: a prospective economic analysis of febrile children attending an NHS emergency department. BMC Med 2019; 17:48. [PMID: 30836976 PMCID: PMC6402102 DOI: 10.1186/s12916-019-1275-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/30/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Paediatric fever is a common cause of emergency department (ED) attendance. A lack of prompt and definitive diagnostics makes it difficult to distinguish viral from potentially life-threatening bacterial causes, necessitating a cautious approach. This may result in extended periods of observation, additional radiography, and the precautionary use of antibiotics (ABs) prior to evidence of bacterial foci. This study examines resource use, service costs, and health outcomes. METHODS We studied an all-year prospective, comprehensive, and representative cohort of 6518 febrile children (aged < 16 years), attending Alder Hey Children's Hospital, an NHS-affiliated paediatric care provider in the North West of England, over a 1-year period. Performing a time-driven and activity-based micro-costing, we estimated the economic impact of managing paediatric febrile illness, with focus on nurse/clinician time, investigations, radiography, and inpatient stay. Using bootstrapped generalised linear modelling (GLM, gamma, log), we identified the patient and healthcare provider characteristics associated with increased resource use, applying retrospective case-note identification to determine rates of potentially avoidable AB prescribing. RESULTS Infants aged less than 3 months incurred significantly higher resource use than any other age group, at £1000.28 [95% CI £82.39-£2993.37] per child, (p < 0.001), while lesser experienced doctors exhibited 3.2-fold [95% CI 2.0-5.1-fold] higher resource use than consultants (p < 0.001). Approximately 32.4% of febrile children received antibiotics, and 7.1% were diagnosed with bacterial infections. Children with viral illnesses for whom antibiotic prescription was potentially avoidable incurred 9.9-fold [95% CI 6.5-13.2-fold] cost increases compared to those not receiving antibiotics, equal to an additional £1352.10 per child, predominantly resulting from a 53.9-h increase in observation and inpatient stay (57.1 vs. 3.2 h). Bootstrapped GLM suggested that infants aged below 3 months and those prompting a respiratory rate 'red flag', treatment by lesser experienced doctors, and Manchester Triage System (MTS) yellow or higher were statistically significant predictors of higher resource use in 100% of bootstrap simulations. CONCLUSION The economic impact of diagnostic uncertainty when managing paediatric febrile illness is significant, and the precautionary use of antibiotics is strongly associated with increased costs. The use of ED resources is highest among infants (aged less than 3 months) and those infants managed by lesser experienced doctors, independent of clinical severity. Diagnostic advances which could increase confidence to withhold antibiotics may yield considerable efficiency gains in these groups, where the perceived risks of failing to identify potentially life-threatening bacterial infections are greatest.
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Affiliation(s)
- Simon Leigh
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby St, Liverpool, L69 7BE UK
- Infectious Diseases Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
| | - Alison Grant
- Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
| | - Nicola Murray
- The Royal Liverpool University Hospital, Prescot St, Liverpool, L7 8XP UK
| | - Brian Faragher
- Medical Statistics Unit, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Henal Desai
- Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE UK
| | - Samantha Dolan
- Royal Bolton Hospital, Minerva Road, Farnworth, BL4 0JR UK
| | - Naeema Cabdi
- School of Medicine, University of Liverpool, Cedar House, Liverpool, L69 3GE UK
| | - James B. Murray
- Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2TH UK
| | - Yasmin Rejaei
- Pinderfields District General Hospital, Aberford Road, Wakefield, WF1 4DG UK
| | - Stephanie Stewart
- Wirral University Teaching Hospital, Arrowe Park Road, Wirral, CH49 5PE UK
| | - Karl Edwardson
- Information Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
| | - Jason Dean
- Finance Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
| | - Bimal Mehta
- Emergency Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
| | - Shunmay Yeung
- Department of Clinical Research, MARCH Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Frans Coenen
- Department of Computer Science, University of Liverpool, Ashton Building, Ashton Street, Liverpool, L693BX UK
| | - Louis W. Niessen
- Department of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine and University of Liverpool, Liverpool, UK
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA USA
| | - Enitan D. Carrol
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby St, Liverpool, L69 7BE UK
- Infectious Diseases Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
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Escobar Tobón AL. La fiebre en el niño: una mirada reflexiva a las prácticas de cuidado. AVANCES EN ENFERMERÍA 2017. [DOI: 10.15446/av.enferm.v35n3.54848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objetivo: Realizar un análisis crítico-reflexivo de las prácticas rutinarias de los profesionales de enfermería y de los cuidadores familiares en el cuidado del niño con fiebre, a fin de incentivar un cuidado basado en evidencia científica que asegure el bienestar infantil.Síntesis de contenido: Se realizó una revisión bibliográfica de artículos científicos publicados entre los años 2007 y 2017, en las bases de datos ebscohost, ScienceDirect, medline, PubMed, cinahl, Web of Science y cuiden®, para lo cual se utilizaron los descriptores y sus combinaciones en español, portugués e inglés Fiebre; Cuidadores; Niño. Se elaboró un compendio de 45 artículos seleccionados y analizados que contenía las prácticas de cuidado con convergencias, divergencias y complementariedades.Los resultados se agruparon en los siguientes cinco temas: Concepción histórica de la fiebre; La fiebrefobia:una concepción en las actuales prácticas de cuidado; El baño de esponja:una práctica ancestral controvertida; El uso de antipiréticos: una rutina en contravía de la salud y la vidade los niños; La fiebre: en busca de una mirada desde su beneficio.Conclusiones: La concepción de la fiebre infantil centrada en el miedo y en el daño permanece. Las acciones de cuidado más comunes, como el baño de esponja y el uso/abuso de antipiréticos, son cuestionadas desde la evidencia científica, demostrando los efectos deletéreos que producen en la salud del niño. El cuidado del niño, después de una evaluación individualizada, deberá enfocarse en el confort, en un ambiente fresco y tranquilo y en el aumento de la ingesta de líquidos para evitar la deshidratación u otras complicaciones.
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