I disagree. This is still the most common issue in the ER and there is still both plenty of controversy in management as well as variation among providers. Consider if the pt returned to the ER the next day in septic shock and died. I can assure you there would be plenty of debate about the assessment and treatment. I personally agree with relying on the exam in older (>6 mos if immunized) infants and children, but this issue if far from settled either in the literature or in practice.
James Reingold, M.D.> Date: Wed, 19 Dec 2007 15:46:56 -0500> From: [log in to unmask]> Subject: Re: fever and antibiotics> To: [log in to unmask]> > I personally cannot believe the amount of traffic an unexplained fever in a > child on an antibiotic(rightly or wrongly) can generate. I thought this > was for new issues in pediatrics, and having finished my residency in 1974, and > practising Emergency Medicine for 27 years I can assure you that rhis child > is not unique in any way, shape or form. What were you taught in your > training? I was taught to look at the child, GET A FEELING FOR WHETHER HE/SHE IS > SICK, AND EITHER DO FURTHUR WORKUP OR NOT DEPENDING ON YOUR CLINICAL > IMPRESSION. Has this changed? I think not, and these types of questions waste our > time!! Gene Saltzberg MD> > > > **************************************See AOL's top rated recipes > (http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)> > For more information, send mail to [log in to unmask] with the message: info PED-EM-L> The URL for the PED-EM-L Web Page is:> http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
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