Fever – Infants 0-90 days: Difference between revisions
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* Milcent, et al. [https://jamanetwork.com/journals/jamapediatrics/fullarticle/2472718 Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants]. JAMA Pediatr. 2016; 170 (1): 62-9. | * Milcent, et al. [https://jamanetwork.com/journals/jamapediatrics/fullarticle/2472718 Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants]. JAMA Pediatr. 2016; 170 (1): 62-9. | ||
* Seattle Children’s Hospital, et al. [http://www.seattlechildrens.org/pdf/neonatal-fever-pathway.pdf Neonatal Fever Pathway]. 2017 February. | * Seattle Children’s Hospital, et al. [http://www.seattlechildrens.org/pdf/neonatal-fever-pathway.pdf Neonatal Fever Pathway]. 2017 February. | ||
* [https://anmc.org/wp-content/uploads/guidelines04182018/D.2-ANMC%20Febrile%20Infant%200-90%20Days%20Clinical%20Guideline%202017.pdf ANMC Clinical Guideline: Fever in Infants 0-90 days old] | * [https://anmc.org/wp-content/uploads/guidelines04182018/D.2-ANMC%20Febrile%20Infant%200-90%20Days%20Clinical%20Guideline%202017.pdf ANMC Clinical Guideline: Fever in Infants 0-90 days old]. 2017. | ||
*[[media:Fever_less_than_90_days.pdf|Fever in infant 0-90 days old YKHC Clinical Guideline]] | *[[media:Fever_less_than_90_days.pdf|Fever in infant 0-90 days old YKHC Clinical Guideline]] | ||
[[:category:YKHC Guidelines]] | [[:category:YKHC Guidelines]] | ||
<br/>[[Practicing Medicine in Bush Alaska—Some ABCs|Common/Unique Medical Diagnoses]] | <br/>[[Practicing Medicine in Bush Alaska—Some ABCs|Common/Unique Medical Diagnoses]] | ||
Revision as of 10:14, 25 September 2020
We follow the generally accepted policy that infants under 3 months of age with a fever of 100.4° or greater should be evaluated in Bethel for severe bacterial infection and sepsis work up as appropriate. The CHA’s are not allowed to give infants less than 3 months of age antibiotics in the village without a physician’s order, and these infants should be evaluated in Bethel before being started on any antibiotic therapy.
Infants with fevers 100.4° or greater that have a normal exam and are clinically stable do not need to be medevaced, but they do need to come to Bethel on the first plane in the morning.
Infants with fever who appear ill, have respiratory distress, or are toxic in appearance should have a medevac arranged, and IM ceftriaxone should be given in the village if any delay is expected. A blood culture should be obtained prior to Ceftriaxone if the patient is in a SRC. Our guideline on management of fever in infants better details our usual management style.
If you have questions upon starting at YKHC, feel free to consult a pediatrician.
Resources/References
- Ishimine, P. The evolving approach to the young child who has fever and no obvious source. Emerg Med Clin North Am. 2007 Nov;25(4):1087-115, vii. doi: 10.1016/j.emc.2007.07.012
- Gomez, et al. Diagnostic Value of Procalcitonin in Well-Appearing Young Febrile Infants. Pediatrics. 2012; 130 (5): 815-22.
- Hui C, et al. Diagnosis and Management of Febrile Infants (0–3 months). Evidence Report/Technology Assessment No. 205 (Prepared by the University of Ottawa Evidence-based Practice Center under Contract No. HHSA 290-2007-10059-I.) AHRQ Publication No. 12-E004-EF. Rockville, MD: Agency for Healthcare Research and Quality. March 2012.
- Milcent, et al. Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants. JAMA Pediatr. 2016; 170 (1): 62-9.
- Seattle Children’s Hospital, et al. Neonatal Fever Pathway. 2017 February.
- ANMC Clinical Guideline: Fever in Infants 0-90 days old. 2017.
- Fever in infant 0-90 days old YKHC Clinical Guideline
