Pediatric Emergencies Brewcast: Pediatric Fever

Pediatric fever management in emergency settings requires a structured, age-stratified approach to balance diagnostic thoroughness with clinical necessity. Fever is defined as a rectal temperature of 100.4°F, with objective measurements superseding parental reports of "feeling warm." Infants under 28 days warrant a full sepsis workup and mandatory admission due to high risks of bacteremia and urinary tract infections. For patients aged 29-90 days, clinical appearance dictates the workup, though urine cultures remain critical. In children aged 3-36 months, management shifts toward identifying specific sources like pneumonia or Kawasaki’s disease, particularly when fever persists beyond five days. Effective clinical practice involves prioritizing symptom-driven testing, such as influenza or urine analysis, while managing parental concerns through clear communication and incremental, evidence-based interventions. This approach minimizes unnecessary procedures while ensuring high-risk conditions are identified and treated promptly.