NICE guideline issued on treating fever in under-5s
Monika Adamczyk/Dreamstime.com
Parents’ perception of their child’s fever should be
taken seriously |
How to assess
and manage young children with a raised temperature is the subject of National Institute for Health and Clinical Excellence guidance published this week.
“Feverish illness in children: assessment and initial management
in children younger than 5 years” is the first national guideline
to provide all health care professionals— including pharmacists,
GPs, nurses and paediatricians — with a
practical “traffic light” tool to assess symptoms and decide
whether a child needs to be referred to a specialist or may be treated
at home.
The tool arranges signs and symptoms in columns — green (low risk),
amber (intermediate risk) and red (high risk). A table of signs and symptoms
suggestive of specific diseases is also given.
The guideline features a section on management by remote access which,
it says, also applies to health care professionals whose scope of practice
does not include the physical examination of children, for example, community
pharmacists. This section advises health care professionals to identify
any immediately life-threatening symptoms, including compromise of the
airway, breathing or circulation, and decreased levels of consciousness.
Children with these symptoms should be referred immediately for emergency
medical care.
Children who have features in the red column but who are not considered
to have an immediately life-threatening illness, should be urgently assessed
by a health care professional in a face-to-face setting within two hours.
Children with amber features should be assessed by a health care professional
face-to-face within a timescale judged to be suitable by the remote assessor,
and children with green features can be managed at home with appropriate
advice, it says.
A section on antipyretic interventions recommends that antipyretics should
not be used routinely in children with fever who are otherwise well but
can be considered in those who appear distressed or unwell.
It adds that either paracetamol or ibuprofen can be used to reduce fever
but advises that they should not be used at the same time and should
not routinely be given alternately. Parental perception of a fever should
be considered valid and taken seriously by health care professionals,
NICE recommends.
|
The
Pharmaceutical Journal
Acrobat
Reader