Aims We undertook this audit to review the management of feverish children in our emergency departments (ED) compared to The College of Emergency Medicine (CEM) standards.
Methods The data was collected using a tool designed by CEM. Entry criteria: under 5 years old and temp >38oC on arrival.
Results Total number of patients was 50. The assessed risk profile for this population (using NICE guidelines) were 24 low risk, 14 intermediate risk, 11 high risk and 1 we were unable to risk stratify from the clinical notes. Nine children were prescribed antibiotics (5 low risk, 2 intermediate and 2 high risk).
Of the 11 patients who were high risk, 7 had a clear source of infection. Of the 4 who had no source identified, one had bloods and urine performed in ED but these were not recorded in the notes. 2 had bloods performed on the paediatric ward.
For the 14 patients in the intermediate risk, 8 had a source of infection, 5 had no obvious source identified and one was not clearly documented. No patients without a source were presecribed antibiotics. No documentation was recorded about discharge advice.
18 patients (36%) did not have a blood pressure (BP) or a capillary refill time (CRT) documented in the notes and 10 patients (20%) did not have their GCS or APVU recorded.
Conclusions There are areas that require review. Improvements must be made to ensure a full set of observations are recorded, emphasising the importance of BP/CRT as well as GCS/AVPU.
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