Pediatric resident management of the young febrile child. 1986

J Zolkowski-Wynne, and J S O'Shea

Identifying the febrile child at risk for serious illness continues to challenge physicians, especially since conflicting guidelines exist for identification and management. This situation poses a special problem for the pediatrician-in-training. In this study the 35 PL-1, P1-2, and PL-3 pediatric house staff of a university-affiliated hospital were surveyed by written questionnaire regarding their practices in dealing with children of less than two years with rectal temperature above 101 degrees F (38.3 degrees C). Uniform replies were received from all house staff concerning the significance of patient age, degree of fever, and laboratory data, although there were some differences of opinion regarding the importance of specific data. All three resident levels tended to reduce the number of laboratory tests obtained as patient age increased, with emphasis placed on clinical impression of illness in assessing the older febrile child. Although the house staff indicated that they were satisfied with their handling of the febrile child, the PL-3s were only marginally more satisfied than the PL-1s and PL-2s. In general, the house staff had most confidence in handling the patient under three months of age, for whom it was generally felt that extensive laboratory evaluations and active management were indicated. The perception of the need for a formal protocol was also greatest for this youngest age group and decreased in importance with age.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D008297 Male Males
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D003955 Diagnostic Tests, Routine Diagnostic procedures, such as laboratory tests and x-rays, routinely performed on all individuals or specified categories of individuals in a specified situation, e.g., patients being admitted to the hospital. These include routine tests administered to neonates. Admission Tests, Routine,Hospital Admission Tests,Physical Examination, Preadmission,Routine Diagnostic Tests,Admission Tests, Hospital,Diagnostic Test, Routine,Diagnostic Tests,Examination, Preadmission Physical,Preadmission Physical Examination,Routine Diagnostic Test,Test, Routine Diagnostic,Tests, Diagnostic,Tests, Hospital Admission,Tests, Routine Diagnostic,Admission Test, Hospital,Admission Test, Routine,Diagnostic Test,Examinations, Preadmission Physical,Hospital Admission Test,Physical Examinations, Preadmission,Preadmission Physical Examinations,Routine Admission Test,Routine Admission Tests,Test, Diagnostic,Test, Hospital Admission,Test, Routine Admission,Tests, Routine Admission
D005260 Female Females
D005334 Fever An abnormal elevation of body temperature, usually as a result of a pathologic process. Pyrexia,Fevers,Pyrexias
D006785 Hospitals, University Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research. University Hospitals
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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