Fever/Sepsis — Pediatric Pearls

What demographic is part of the pediatric fever history?

Age.

What time element of fever is gathered?

Duration of fever.

What magnitude element of fever is gathered?

Severity of fever.

What general history is gathered in pediatric fever?

Past medical history.

What drug history is gathered in pediatric fever?

Medications.

What immune status history is gathered in pediatric fever?

Immunocompromised status.

What conditions are listed as immunocompromising in pediatric fever history?

Transplant, HIV, diabetes, or cancer.

What exposure history is gathered in pediatric fever?

Environmental exposure.

What antipyretic history is gathered in pediatric fever?

Last acetaminophen or ibuprofen.

When should the approximate weight-for-age table be used?

Only if a Broselow-Luten tape cannot be used.

What is the approximate weight-for-age table based on?

CDC Growth Rate Tables.

What percentile does the weight-for-age table represent?

The 50th percentile (median) of US infants and children.

What is the recommended exam in pediatric fever?

Mental status, skin, HEENT, neck, heart, lungs, abdomen, back, extremities, neurologic.

Which children are more likely to have febrile seizures?

Those with a history of febrile seizures and a rapid elevation in temperature.

Which patients should not receive acetaminophen?

Patients with a history of liver failure or liver disease.

Which patients should not receive NSAIDs in pediatric fever?

Renal transplant or renal disease patients.

How does rehydration with fluids help a febrile patient?

It increases the ability to sweat and improves temperature control.

What is a contraindication to ibuprofen?

An allergy to NSAIDs.

What must be considered as a cause of elevated temperature besides fever?

A possible environmental heat emergency.

Should NSAIDs be used in environmental heat emergencies?

No.

Should aspirin be given to a child?

No.

What is recommended for rapid cooling measures?

Removal of clothes.

How long must pass before giving a different antipyretic than one already taken?

2 hours.

Can the same antipyretic type be given after a home dose?

No, even if the maximum allowable has not been reached.

What is the max dose of acetaminophen per 24 hour period?

4000 mg.

What is the max dose of ibuprofen per 24 hour period?

40 mg/kg.

What is the normal heart rate for a neonate (0 to 28 days old)?

100 to 205 bpm.

What is the normal respiratory rate for a neonate (0 to 28 days old)?

30 to 53 bpm.

What is the normal systolic BP for a neonate (0 to 28 days old)?

60 to 84 mmHg.

What is the normal diastolic BP for a neonate (0 to 28 days old)?

31 to 53 mmHg.

What is the normal heart rate for an infant (1 month to 1 year old)?

100 to 190 bpm.

What is the normal respiratory rate for an infant (1 month to 1 year old)?

30 to 53 bpm.

What is the normal systolic BP for an infant (1 month to 1 year old)?

72 to 104 mmHg.

What is the normal diastolic BP for an infant (1 month to 1 year old)?

37 to 56 mmHg.

What is the normal heart rate for a toddler (1 to 2 years old)?

98 to 140 bpm.

What is the normal respiratory rate for a toddler (1 to 2 years old)?

22 to 37 bpm.

What is the normal systolic BP for a toddler (1 to 2 years old)?

86 to 106 mmHg.

What is the normal diastolic BP for a toddler (1 to 2 years old)?

42 to 63 mmHg.

What is the normal heart rate for a preschooler (3 to 5 years old)?

80 to 120 bpm.

What is the normal respiratory rate for a preschooler (3 to 5 years old)?

20 to 28 bpm.

What is the normal systolic BP for a preschooler (3 to 5 years old)?

89 to 112 mmHg.

What is the normal diastolic BP for a preschooler (3 to 5 years old)?

46 to 72 mmHg.

What is the normal heart rate for a school-aged child (6 to 11 years old)?

75 to 118 bpm.

What is the normal respiratory rate for a school-aged child (6 to 11 years old)?

18 to 25 bpm.

What is the normal systolic BP for a school-aged child (6 to 11 years old)?

97 to 120 mmHg.

What is the normal diastolic BP for a school-aged child (6 to 11 years old)?

57 to 80 mmHg.

What is the normal heart rate for an adolescent (12 to 15 years old)?

60 to 100 bpm.

What is the normal respiratory rate for an adolescent (12 to 15 years old)?

12 to 20 bpm.

What is the normal systolic BP for an adolescent (12 to 15 years old)?

110 to 131 mmHg.

What is the normal diastolic BP for an adolescent (12 to 15 years old)?

64 to 83 mmHg.

What is the approximate weight of a term neonate male?

4 kg (8.8 lbs).

What is the approximate weight of a term neonate female?

4 kg (8.8 lbs).

What is the approximate weight of a 1 month old male?

4 kg (9.9 lbs).

What is the approximate weight of a 1 month old female?

4 kg (9.3 lbs).

What is the approximate weight of a 2 month old male?

5 kg (11.7 lbs).

What is the approximate weight of a 2 month old female?

5 kg (10.8 lbs).

What is the approximate weight of a 3 month old male?

6 kg (13.4 lbs).

What is the approximate weight of a 3 month old female?

5 kg (12.3 lbs).

What is the approximate weight of a 4 month old male?

6 kg (14.9 lbs).

What is the approximate weight of a 4 month old female?

6 kg (13.6 lbs).

What is the approximate weight of a 5 month old male?

7 kg (16.2 lbs).

What is the approximate weight of a 5 month old female?

6 kg (14.8 lbs).

What is the approximate weight of a 6 month old male?

8 kg (17.5 lbs).

What is the approximate weight of a 6 month old female?

7 kg (15.9 lbs).

What is the approximate weight of a 7 month old male?

8 kg (18.6 lbs).

What is the approximate weight of a 7 month old female?

8 kg (17.0 lbs).

What is the approximate weight of an 8 month old male?

9 kg (19.6 lbs).

What is the approximate weight of an 8 month old female?

8 kg (17.9 lbs).

What is the approximate weight of a 9 month old male?

9 kg (20.5 lbs).

What is the approximate weight of a 9 month old female?

9 kg (18.8 lbs).

What is the approximate weight of a 10 month old male?

10 kg (21.3 lbs).

What is the approximate weight of a 10 month old female?

9 kg (19.6 lbs).

What is the approximate weight of an 11 month old male?

10 kg (22.1 lbs).

What is the approximate weight of an 11 month old female?

9 kg (20.3 lbs).

What is the approximate weight of a 1 year old male?

10 kg (22.8 lbs).

What is the approximate weight of a 1 year old female?

10 kg (21.0 lbs).

What is the approximate weight of an 18 month old male?

12 kg (25.8 lbs).

What is the approximate weight of an 18 month old female?

11 kg (24.2 lbs).

What is the approximate weight of a 2 year old male?

13 kg (27.9 lbs).

What is the approximate weight of a 2 year old female?

12 kg (26.6 lbs).

What is the approximate weight of a 3 year old male?

14 kg (31.6 lbs).

What is the approximate weight of a 3 year old female?

14 kg (30.6 lbs).

What is the approximate weight of a 4 year old male?

16 kg (35.8 lbs).

What is the approximate weight of a 4 year old female?

16 kg (34.8 lbs).

What is the approximate weight of a 5 year old male?

18 kg (40.5 lbs).

What is the approximate weight of a 5 year old female?

18 kg (39.5 lbs).

What is the approximate weight of a 6 year old male?

21 kg (45.6 lbs).

What is the approximate weight of a 6 year old female?

20 kg (44.6 lbs).

What is the approximate weight of a 7 year old male?

23 kg (50.8 lbs).

What is the approximate weight of a 7 year old female?

21 kg (50.2 lbs).

What is the approximate weight of an 8 year old male?

26 kg (56.5 lbs).

What is the approximate weight of an 8 year old female?

26 kg (56.5 lbs).

What is the approximate weight of a 9 year old male?

29 kg (62.9 lbs).

What is the approximate weight of a 9 year old female?

29 kg (63.9 lbs).

What is the approximate weight of a 10 year old male?

32 kg (70.4 lbs).

What is the approximate weight of a 10 year old female?

33 kg (72.5 lbs).

What is the approximate weight of an 11 year old male?

36 kg (79.1 lbs).

What is the approximate weight of an 11 year old female?

37 kg (82.0 lbs).

What is the approximate weight of a 12 year old male?

40 kg (89.2 lbs).

What is the approximate weight of a 12 year old female?

42 kg (91.8 lbs).