| hochfibril highly febrile
Explanation:
Hi Nicole,
Here is my answer, once again:
hochfebril = highly febrile
Patterns of Illness in the ***Highly Febrile*** Young Child: Epidemiologic, Clinical, and Laboratory Correlates
Peter F. Wright MD1, Juliette Thompson RN1, Kelly T. Mckee Jr MD1, William K. Vaughn PhD1, Sarah H. W. Sell MD1, and David T. Karzon MD1
1 Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
Three hundred one episodes of fever 103 F were documented in 375 infants and young children observed in a comprehensive care clinic during the period October 1974 to October 1978. Of such ***highly febrile*** illnesses 79% were accompanied by respiratory tract signs or symptoms, 7% by disease at a site other than the respiratory tract, and 22% of illnesses had no localizing signs or symptoms. Viral cultures were obtained from the respiratory tract in 178 cases and were positive in 68:57/ 134 from respiratory illness; 2/4 from illness at sites other than the respiratory tract; and 9/40 in children without localizing disease. Bacterial cultures of the upper respiratory tract were obtained in 191 illnesses, but the overall rate of isolation of Haemophilus influenzae, Streptococcus pneumoniae and group A streptococci (46%) did not differ from that in a group of well children (39%). Bacterial cultures of the blood were obtained in 89 patients with fever 103 F and in an additional 41 children with lower temperatures. Nine children had documented systemic bacterial disease (eight positive blood cultures and one positive CSF). The rate of clinically apparent systemic bacterial disease in these otherwise normal infants was one bacteremic episode per 94 years of child care.
http://pediatrics.aappublications.org/cgi/content/abstract/6...
The ESI Triage Research Team recommends that vital signs in patients under age 3 be assessed at triage. In particular, temperature measurement is important during triage of all children from newborn through 36 months of age, and vital sign evaluation is essential to the overall assessment of a known febrile infant under age 36 months (Baraff, 2000). This helps to differentiate ESI level-2 and 3 patients and minimize the risk that potentially bacteremic children will be sent to an express care area or otherwise experience an inappropriate wait. Remember, if a patient is in immediate danger or high risk, he or she will be assigned to either ESI level 1 or 2.
Table 6-3 provides direction for the triage nurse in using the ESI to assess the febrile child and determine the most appropriate triage level. The generally accepted definition of fever is a rectal temperature greater than 38.0° C (100.4° F) (Baraff, et al., 1993; ACEP, 2003). The infant less than 28 days old with a fever should be considered high risk and assigned to at least ESI level 2. There are no clear guidelines for the infant between 28 days and 3 months of age. The ESI research team recommends triage nurses rely on local hospital guidelines. We suggest that the nurse consider assigning at least an ESI level 2 for such patients.
In v. 4 of the ESI, we have incorporated a different set of pediatric fever guidelines for children ages 3 to 36 months. These pediatric fever considerations pertain to ***highly febrile children, defined as those with a fever of greater than 39.0° C (102.2° F)*** (ACEP, 2003). When triaging a child between 3 and 36 months of age who is highly febrile, it is important for the triage nurse to assess the child's immunization status and whether there is an identifiable source for the fever.
The patient with incomplete immunizations or with no identifiable source for the fever should be assigned to at least ESI level 3. If the patient has an identifiable source for the fever and his or her immunizations are up to date, then a rating of 4 or 5 is appropriate. For example, a 7-month-old who is followed by a pediatrician, has had the Haemophilus influenza type b (HIB) vaccine and presents with a fever and pulling on his ear could be assigned to an ESI level 5.
http://www.ahrq.gov/research/esi/esi6.htm
| Patricia Daehler
United States
Local time: 09:06
Specializes in field
Native speaker of: German
PRO pts in category: 491
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peer agreement (net): +2
