>How about
>* 'Unwell' child with no localising signs
>* History or Family history of Febrile Convulsions
>* First Convulsion
>* Immunocompromised
>* Natural Contraception
>
>Regards
>Joegy Shah, GP, Lancashire
I think these are interesting suggestions and even agree that fertility
thermometers may have a place for a few people. Not a doctor role though ;-)
Haven't checked these and would be interested in views but...
Isn't fever unreliable in the immunocompromised? I thought they could have
serious infections with little in the way of fever. One of the big problems.
First convulsion
Was taught that many patients will demonstrate a fever if temperature taken as
a fit has just ended. ?Metabolic effects of convulsing? Hence not a reliable
guide, and as the differential of febrile convulsion includes meningitis not
sure that it helps either way. Perhaps there are other angles on this?
Hx or FH of Febrile convulsions. Parents may want to take temp in this
situation, but again I "thought" (i.e. can't quote the source) that while we
continue to advise parents to treat fever promptly with this history, there is
no evidence this makes any difference. Even if it did, again not really a
doctor taken temp.
Unwell child with no localising signs. (I presume after thorough exam and
urine dipstix)
Older children:-
Not feverish, not flu, probably wait and see.
Feverish, probably flu, probably wait and see.
Might specifically ask parent to take temperature regularly.. do this from time
to time and still don't feel the need to take myself.. perhaps it's just my
patients are too polite to say anything.
Younger children
This is one where I might. Especially in v. young children a high fever could
be a marker of more serious disease. Think this was established as part of the
Baby Check research.
Again, interesting suggestions,
Julian
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|