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Journal of Public Health Policy and Planning | Volume 3
April 08-09, 2019 | Zurich, Switzerland
Health Care and Neuroscience
International Conference on
Management of febrile children is an intrinsic aspect of pediatric pracƟce
Sherif Ibrahim Hussein Bakir
Emirates Hospital, UAE
F
ebrile children account for 15% of emergency
department visits and outcomes range from the
presence of serious bacterial infection to benign self-
limited illness. A clinically significant fever in children
younger than 36 months is a rectal temperature
of at least 100.4°F (38°C). Axillary, tympanic, and
temporal artery measurements have been shown
to be unreliable. 15–18 Neonates whose parents
report a clinically significant fever may have a serious
bacterial infection, even if they do not have a fever
at the time of their initial medical evaluation. The
evaluation of febrile children younger than 36 months
has long presented the challenge for physicians
of ensuring that children with serious bacterial
infection are appropriately identified and treated,
while minimizing the risks associated with invasive
testing, hospitalization, and antibiotic treatment.
The epidemiology of febrile illness in children has
changed dramatically with the introduction of several
vaccines targeted at this age group, and with the use
of antibiotic prophylaxis during childbirth. Because
of this, earlier guidelines have been questioned. This
article focuses on previously healthy febrile children
younger than 36 months. Those with significant
pre-existing conditions (e.g., prematurity, immune
compromise) should be evaluated on a case-by-case
basis. The oral and rectal routes should not routinely
be used to measure the body temperature of children
aged 0–5 years. In infants under the age of 4 weeks,
body temperature should be measured with an
electronic thermometer in the axilla. In children aged
4 weeks to 5 years, healthcare professionals should
measure body temperature by one of the following
methods:
• Electronic thermometer in the axilla
• Chemical dot thermometer in the axilla
• Infrared tympanic thermometer
Forehead chemical thermometers are unreliable and
should not be used by healthcare professionals.
Reported parental perception of a fever should be
considered valid and taken seriously by healthcare
professionals.
• Clinical red flags for serious infection in children
more than one month:
• Global Assessment: Parental Concerns,
Physician instinct
• Child behavior: Changes in crying pattern,
Drowsiness, Consolability, Moaning
• Circulatory or Respiratory: Crackles, Cyanosis.
Decreased breath sounds. Poor peripheral
circulation, Rapid breathing, Shortness of breath
• Other Factors: Decreased Skin elasticity,
Hypotension, Meningeal irritation, Petichial rash,
Seizures, Unconsciousness.
Speaker Biography
Sherif Ibrahim Hussein Bakir is a Consultant Pediatrician at Emirates hospital
clinics in Fujairah since February 2017 till now. He has 35 years of experience
in Neonatology, Pediatric Allergy, immunology and General Pediatrics. He
completed his MD pediatrics at Cairo university in the year 1998 and Msc.
Pediatrics at Azhar university in 1984. MBBch AIN Shams University 1979.
EAACI membership (European Academy of Allergy and clinical immunology)
Egyptian Neonatology society Egypt.
e:
drsbakir2002@gmail.com