Nice | Feverish illness in children

This guideline is an update of the 2007 version. There is nothing mind-boggling here, but it's worth printing out a new version of the 'traffic-light' sheet.

They have handy 'parent information sheets' that you can print out too. The sections on 'Caring for your child at home' and 'Seeking further advice' are useful for safety-netting.

So what's changed? I've summarised the most important changes or things that haven't changed but are good to remember:
Tachycardia has been defined and age specific ranges given (see the new 'traffic-light sheet' (new).
Duration of fever shouldn't be used as a risk factor, but remember Kawasaki disease if they've had fever for over 5 days (new).
Remote Assessment. If you are assessing a child over the phone, any red features should prompt a face to face review within 2 hrs (not new).
Antipyretics. The advice before was 'only 1 at a time'. Did anyone do this? Anyway, they've now advised that parents can add in the second agent if the first alone isn't controlling symptoms (new).
Red Features. This is stated as being for secondary care, but probably applies to us too. If you have a child with 'red features' and give them antipyretics, don't judge severity of illness by a fall in temperature, or by the lack of a fall. All these kids need a full reassessment regardless (new).

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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2 Responses

  1. Really useful- thanks Louise
  2. Yep, certainly learnt a few things here!

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