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I shall break my lurking on this list.

As a generalist who has spent 17 years doing community ER work this  
child would get no workup and no prescription, but would definitely be  
invited to return the next day if they could not get into their  
private physician for reassessment.  Of course they would get the  
fever handout.

Terence Bergmann


On 21-Feb-08, at 8:23 PM, Rob Ojala wrote:

> May I ask this.....?
> If you were a family physician [what we call a GP] and a 4 month old
> arrived at your practice with temp 38.9 and cough and was 'non-toxic'
> would you routinely send them to hospital for a septic work up? [I
> appreciate there are differences in patient cohort between ED versus
> community].
> Would you 'cath' them etc?
>
> I hope my children wouldn't be subjected to that approach.
>
> Rob Ojala
>
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List
> [mailto:[log in to unmask]] On Behalf Of [log in to unmask]
> Sent: Friday, 22 February 2008 12:25 p.m.
> To: [log in to unmask]
> Subject: Re: a 4 months old with cough
>
> so far I get a lot of opinions based on established practice and  
> common
>
> sense .
> I hope to get a reference that will define the very low risk  
> population
>
> where this practice  is safe, If that non toxic non distressed baby   
> had
> higher
> temperature, Say 102F (38.9C) with that cough will you still  not cath
> the
> bladder ? if this was a 7 month old girl ( a patient of ours today)
> with the same
> presentation, will you still manage the same way?
> This has been a topic of fierce debate among us today and I hope to  
> get
> some
> help from those who are familiar with the studies on that issue
>
> thanks again...
> Giora Winnik
> Maimonides
> Brooklyn
>
>
>
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