Management of the acute febrile child in the ED
Keywords:
FEVER, PEDIATRICS, DEHYDRATION, TREATMENT.Abstract
Introduction: fever is a response to the release of endogenous pyrogenic mediators called cytokines (in particular, interleukin-1 [IL-1]). Cytokines stimulate the production of prostaglandins by the hypothalamus; prostaglandins reset and raise the temperature set point. Knowledge of fever is vital in pediatric practice.
Objective: to describe the essential elements in the management of the acute febrile child in the emergency department.
Methods: for this bibliographic review, 38 research studies on the subject were consulted, obtained from national and foreign medical journals indexed in SciELO, IMBIOMED, PubMed, Latindex, Google Scholar, DOAJ, Dialnet, Medline and Scopus and 29 were used as bibliographies, with a predominance of articles published during the last five years and others due to their relevance.
Development: fever is one of the most frequent reasons for consultation in Pediatrics, especially between 3-36 months of life, and up to 65 % of children under two years of age will consult for this reason. It accounts for 10-20 % of acute processes in Primary Care and up to 30 % in Hospital Emergency Departments, especially in winter, coinciding with epidemics of respiratory and gastrointestinal viruses.
Conclusions: the possibility of a serious bacterial infection makes it essential to carry out an adequate assessment of each child with fever that we treat. For this reason, physicians should have an optimal preparation on the management and adequate treatment of the febrile child at any level of care.
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