Fever in Children Aged 3 to 36 Months: Management in the Emergency Department

Points & Pearls Excerpt

• Fever of concern in a well child is ≥39°C.²
• In general, fever measured at home may be evaluated as fever in the ED even if the child is afebrile at presentation.
• A meta-analysis found that all peripheral methods of thermometry have poor limits of agreement with central methods such as rectal thermometry.⁷¹
• When a temperature measured by means other than rectal is necessary, the best alternatives are oral, then tympanic measurements.^71,72
• The pediatric assessment triangle (PAT) can be used to assess the ABCs—appearance, work of breathing, circulation to the skin. (See Table 2.) If the PAT assessment indicates an ill-appearing child, interventions are tailored to the child based on the physiologic category.