Document Detail


Fever determination in young infants: prevalence and accuracy of parental palpation.
MedLine Citation:
PMID:  19116500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Pediatricians routinely advise parents to seek immediate medical attention if their young infant develops a fever. Many parents rely on palpation to assess their child's temperature. Our objective was to determine the prevalence and accuracy of parental palpation for fever in young infants. METHODS: We enrolled a convenience sample of infants younger than 3 months presenting to a pediatric emergency department with any complaint. Parents answered questions regarding their usual fever determination practices and palpated their infants to assess for fever. Parental predictions were then compared with the standard rectal temperature obtained at triage. RESULTS: Ninety-six infants were enrolled. Fifty-seven percent of parents reported palpation as a usual method of fever assessment, with 87% palpating for fever at least occasionally. Of the 78% of parents who owned a thermometer, nearly half used palpation regularly. As compared with the "gold standard" of rectal thermometry, parental palpation for fever had a sensitivity of 81%, specificity of 82%, positive predictive value of 59% and negative predictive value of 93%. After eliminating from analysis those infants whose parents had used a thermometer at home, we found a sensitivity of 67%, specificity of 84%, positive predictive value of 33%, and negative predictive value of 95%. CONCLUSIONS: Many parents rely on palpation as a usual method of fever determination in young infants, including nearly half of those who own a thermometer. Parental palpation overestimates the presence of fever, but is likely to be accurate when parents report that their baby is not febrile. As a sole method of determining fever, parental palpation is unreliable.
Authors:
Rachel J Katz-Sidlow; Justin P Rowberry; Marilyn Ho
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  25     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-20     Completed Date:  2009-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  12-4     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA. Rachel.Katz@nbhn.net
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MeSH Terms
Descriptor/Qualifier:
Emergency Service, Hospital / statistics & numerical data
Female
Fever / diagnosis*
Forehead
Hospitals, Public / statistics & numerical data
Hospitals, Urban / statistics & numerical data
Humans
Infant
Infant Care / statistics & numerical data*
Infant, Newborn
Male
New York City / epidemiology
Palpation / utilization*
Parenting* / psychology
Parents / psychology*
Predictive Value of Tests
Reproducibility of Results
Sensitivity and Specificity
Thermometers / utilization*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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