Template
Febrile infant 8-60 days
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Age groupChoose oneFirst line
Pathway criteriaChoose any
TemperatureChoose any
PlanChoose one
TestingChoose anyNot in the note with these choices
Home criteriaChoose anyNot in the note with these choices
Follow-upChoose oneNot in the note with these choices
Follow-up reasonChoose anyJoins the line aboveNot in the note with these choices
Counseling
Discussed why a young infant with fever needs prompt evaluation in the hospital. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
We will call with culture results. Recommended supportive care with an emphasis on hydration with frequent feeds and watching closely at home. Call right away or go to the emergency department for poor feeding, fewer wet diapers, unusual sleepiness or difficulty waking, trouble breathing, color change, vomiting, or a new rash. Return precautions given including fever that continues, fussiness that cannot be consoled, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- Age group 8-21 or 22-28 or 29-60
- Inclusion: well appearing, term, no vaccines in 48 h, no focal bacterial infection
- UA (cath or bag), blood culture, IMs (procalcitonin, CRP, ANC)
- 8-21 days: hospitalize and treat
- 29-60 days, UA and IMs normal: home, no antibiotics, recheck 24 h
- 29-60 days, UA positive, IMs normal: oral antibiotics
- 22-28 days home option with parenteral antibiotics
- Home criteria: phone, transportation, 24 h recheck
- Viral testing doesn't change pathway entry
Used to decide, kept out of the note
- Exclusions: preterm, perinatal complications, HSV concern, bronchiolitis, immunocompromise, technology-dependent
- Exam list (fussy, inconsolable, dehydration, WOB, AOM, rash)