Fatigue

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Red flags presentChoose any

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Note when inserted as is

Fatigue
• Fatigue most consistent with common lifestyle contributors, with a broad differential considered
• Reviewed sleep, hydration, nutrition, activity, screen time, mood, and recent illness as common contributors
• No persistent fever, weight loss, night sweats, unexplained bruising, loud snoring, joint pain or swelling, excessive thirst, or symptoms with exercise
• Well appearing with a reassuring exam, including no pallor, lymphadenopathy, or hepatosplenomegaly
• Labs deferred given a reassuring history and exam
• Recommended a symptom and sleep diary
• Counseled on a regular sleep schedule, screens off before bed, regular meals, water, and daily physical activity
• Follow up in 2-4 weeks if not improving

Tiredness in children and teens most often comes from not enough sleep, a late sleep schedule, stress, or a recent illness, and it improves with steady routines. Recommended supportive care with an emphasis on a regular sleep schedule, screens off before bed, regular meals, water, and daily activity. Return precautions given including fever that will not go away, weight loss, night sweats, fainting, chest pain or trouble breathing, weakness, trouble waking up, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Assessment vs sleep, post-viral, needs evaluation
Contributors reviewed
Contributing factors present
Red flags present or absent (fever, weight loss, night sweats, pallor or bruising, snoring, joints, thirst, exertional symptoms)
Depression screen
"Screening labs to be considered"
Sleep plan, gradual return, behavioral health, school note
Sleep or cardiology referral

Return precautions in the template

fever that will not go awayweight lossnight sweatsfaintingchest pain or trouble breathingweaknesstrouble waking up

Sources

AAP Policy Statement, Sudden Death in the Young: Information for the Primary Care Provider (2021)

Few formal guidelines cover this topic, so the template also leans on expert opinion.