The Resus Room Paediatric Fever; Roadside to Resus
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Jan 15, 2024 Exploring the challenges of managing pediatric fever and differentiating serious illnesses from self-limiting ones. Discussing fever thresholds, febrile seizures, Kawasaki disease, pediatric dehydration, and dispelling myths about fever reduction in children. Highlighting the importance of proper assessment and management by pediatric specialists.
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Fever Is A Regulated, Helpful Response
- Fever is a regulated rise in core temperature driven by a raised hypothalamic set point via pyrogens and PGE2.
- Fever usually helps fight pathogens by slowing replication and boosting immune responses.
High Volume, Low Seriousness Overall
- Fever is extremely common in children but serious bacterial infection prevalence is low in primary care (<1%).
- ED prevalence of serious illness can be higher, so context and setting matter for risk.
How Pyrogens Raise Temperature
- Pyrogens (exogenous and endogenous) raise the hypothalamic set point via PGE2 produced by COX-2, causing shivering and vasoconstriction.
- Paracetamol and ibuprofen lower fever by inhibiting cyclooxygenase and reducing PGE2 production.