How does temperature measurement at home affect emergent management of pediatric patients with fever?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Answer

Some pediatric patients may have had a subjective determination of an elevated temperature by their caregivers before coming to the hospital but are afebrile when they present to the ED. Parents may report a temperature elevation in their child without having actually recorded the temperature with a thermometer.

Parental reporting of fever on the basis of subjective information (eg, touching the child's torso or extremities or feeling his or her forehead) is a reliable indicator of a fever having been present. Studies have shown that the parental assessment of fever in this situation is usually accurate. [14] On the other hand, one study found that the subjective history of fever in such infants may not correlate with subsequent fever, whereas those with an elevated rectal temperature measured at home had relatively high rates of serious bacterial infection. [15]

Home use of temporal artery thermometers have not been shown to be completely reliable indicators of febrile children. [16]

Fever phobia

Parents may be overly concerned about possible outcomes of prolonged high temperature, or they may believe that every fever requires antibiotic therapy. [17, 18] These usually unwarranted fears have been shown to vary by race and ethnicity, as well as by the age of the child and parental education level. [9, 19, 20]


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