Paediatrics

The feverish child

Fever is a common, non-specific response that ranges from self-limiting viral illness to life-threatening sepsis; structured assessment of airway, breathing, circulation, behaviour, hydration, age and source of infection determines urgency.

Definition

A feverish child is a child under 5 with measured or reported fever requiring assessment for serious illness, source of infection and hydration. NICE NG143 uses a traffic-light system to stratify risk and guide referral, investigation, treatment and safety-netting.

First principles

Temperature is not a severity score

The height or duration of fever alone does not reliably distinguish serious from non-serious illness, particularly in children over 6 months. Assess the child in front of you: colour, responsiveness, breathing, circulation, hydration, urine output and the trajectory of the illness.

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This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.