Management of fever in children under 5 years of age within paediatric emergency department

Abstract

Background Fever is one of the commonest reasons for presentation to healthcare services. It is often a cause of concern for parents and can be diagnostically challenging for healthcare professionals. Abiding by established guidelines on fever management is therefore of utmost importance to ensure proper use of antipyretics within the community. Objectives This audit aimed to assess the management of children aged up to 5 years presenting with fever to the Paediatric Emergency Department at Mater Dei Hospital, including assessing awareness of NICE guidelines on fever management amongst paediatric doctors and nurses. Method Data was collected from Paediatric Emergency Department Assessment Sheets for January 2017. An online questionnaire based on the NICE guidelines for fever management in children under 5 years was distributed to staff working within the Department of Child and Adolescent Health. Results 255 children aged up to 5 years presented with fever at the Paediatric Emergency Department in January 2017. 22.7% of children were aged between 24 months up to 3 years. The average time for first medical contact was 51 minutes. 23.9% presented with fever of 1 day duration. Respiratory rate was not recorded in 62% of cases whilst blood pressure was only recorded in 19.1% where applicable. Antipyretics were given in 73.8% of febrile cases despite distress only being documented in 6.8%. Conclusion More education is required on proper antipyretic use and pre-discharge advice. Routine measurement and documentation of all parameters should be encouraged both on initial assessment and pre-discharge.