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Episode:

Fever: NICE to get guidance
Category: Science & Medicine
Duration: 01:00:15
Publish Date: 2010-12-16 06:52:32
Description:

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Three years ago the National Institute for Clinical Excellence in the UK released their guidance on the assessment and initial management of feverish illness in young children (CG47).  Most of the world outside of Britain has not been using this guidance, but we thought it would be useful to delve a bit deeper to see whether we could all benefit from the insights of their expert panel.

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Outline of this PEMcast

CP: Intro, hello, disclaimer

NICE CG47 Issued in May 2007, referenced in:

Richardson M, Lakhanpaul M; Guideline Development Group and the Technical Team.
Assessment and initial management of feverish illness in children younger than 5 years: summary of NICE guidance.
BMJ. 2007; 334: 1163-4

Richardson M, Lakhanpaul M.
Feverish illness in children under 5 years.
Arch Dis Child Educ Pract Ed. 2008; 93: 26-9

Main part of discussion centres around NICE CG47 (Full Guideline) Section 4:
Clinical assessment of the child with fever

CP: 4.1 Introduction

SF: 4.2 Priorities in Clinical Assessment

KB: 4.3 Life-Threatening features of Illness in Children

CP: 4.4.1-4.4.2 Assessment of Risk of Serious Illness and Traffic Light system

KB: Traffic lights: green components

SF: Traffic lights: orange

CP: Traffic lights: red

All: comments & discussion on traffic light components

CP: 4.5 Non-Specific symptoms and signs of Serious Illness

Big sections:

SF: 4.5.1 General Symptoms and Signs

KB 4.5.2 Predictive Values of common Physiological Measurements

CP 4.5.3 Height and Duration of Fever

SF 4.5.4 Assessment of Dehydration

CP 4.6 Specific Serious Illnesses – not discussing (will discuss on future episodes though)

With reference to Quick Reference Guideline:

SF: Overview of care pathway – page 4

KB: Assessment – page 8

CP: Introduction to management remote vs normal doctor vs paediatrician

Perspective from position of:

  • KB: remote assessment
  • CP: non-paediatric doctor
  • SF: paediatrician

Would you use the guideline, would you stick to it?
Would you feel protected if something went wrong?

CP/ All: Outcomes / impact of NICE CG47, discussion, perspective & experience from clinical experience.

CP/All: Summary

Goodbye, thanks, see you next time…

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