PMID: 11334099May 4, 2001Paper

Management of febrile infants and children by pediatric emergency medicine and emergency medicine: comparison with practice guidelines

Pediatric Emergency Care
R A BelferA E Muñiz

Abstract

Management of febrile infants and children remains controversial despite the 1993 publication in Pediatrics and Annals of Emergency Medicine of practice guidelines. Our aim was to determine the management of febrile infants and children by pediatric emergency medicine (PEM) fellowship directors and emergency medicine (EM) residency directors and compare their approach with the published practice guidelines. Four case scenarios were sent to 64 PEM directors and 100 EM directors in the United States and Canada, describing four febrile, nontoxic infants and children aged 25 days (case 1), 7 weeks (case 2), 5 months (case 3), and 22 months (case 4). Respondents were asked to select which laboratory tests and radiographs they would obtain and to decide on treatment and disposition for each hypothetical case. Ninety-two percent (53/64) of PEM directors and 64% (64/100) of EM directors responded (overall response rate 74%). Compliance with the guidelines (PEM/EM) was 54%/16% for case 1, 31%/6% for case 2, 35%/19% for case 3, and 20%/11% for case 4. Only 11% of PEM and 2% of EM directors followed the guidelines for all four cases. Overall, directors performed fewer laboratory tests, ordered more chest radiographs and treated fewer pati...Continue Reading

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Citations

Mar 8, 2008·JAAPA : Official Journal of the American Academy of Physician Assistants·Joseph V DobsonRamsay Lee
Jul 14, 2009·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Santiago MintegiSilvia Garcia
May 23, 2008·Pediatric Emergency Care·William P Meehan, Richard G Bachur
Jun 15, 2013·Risk Management and Healthcare Policy·Ahmed Farag ElhassanienFawaz Alrefaee
Aug 1, 2006·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·Keng Boon Harold Tan
Aug 7, 2013·Emergency Medicine Clinics of North America·Paul Ishimine
Oct 24, 2007·Emergency Medicine Clinics of North America·Paul Ishimine
Apr 1, 2006·Pediatric Clinics of North America·Paul Ishimine
Apr 21, 2007·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Rachel M StanleyUNKNOWN Pediatric Emergency Care Applied Research Network
Apr 27, 2016·Pediatric Emergency Care·Sonal ShahMark I Neuman
Mar 30, 2017·Pediatric Emergency Care·Nnenna O ChimeUNKNOWN International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) IMPACTS Investigators
Jul 1, 2009·Clinical Pediatrics·Catherine C FergusonLalit Bajaj
Apr 26, 2017·Pediatric Emergency Care·Constance GongTodd A Florin
Sep 27, 2016·Pediatric Emergency Care·Nnenna Ogochukwu ChimeUNKNOWN INSPIRE Network
Nov 28, 2013·Academic Medicine : Journal of the Association of American Medical Colleges·Todd P ChangUNKNOWN International Simulation in Pediatric Innovation, Research, and Education (INSPIRE) Network
Aug 7, 2019·Global Pediatric Health·Winston WuCourtney Mann
Aug 29, 2020·The Pediatric Infectious Disease Journal·Nikki N KlarenbeekFrans B Plötz
Nov 2, 2020·The Journal of Pediatrics·Courtney CoyleJulie C Leonard

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