| Management of febrile infants and children by pediatric emergency medicine and emergency medicine: comparison with practice guidelines. | |
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MedLine Citation:
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PMID: 11334099 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Management of febrile infants and children remains controversial despite the 1993 publication in Pediatrics and Annals of Emergency Medicine of practice guidelines. Our aim was to determine the management of febrile infants and children by pediatric emergency medicine (PEM) fellowship directors and emergency medicine (EM) residency directors and compare their approach with the published practice guidelines. METHODS: Four case scenarios were sent to 64 PEM directors and 100 EM directors in the United States and Canada, describing four febrile, nontoxic infants and children aged 25 days (case 1), 7 weeks (case 2), 5 months (case 3), and 22 months (case 4). Respondents were asked to select which laboratory tests and radiographs they would obtain and to decide on treatment and disposition for each hypothetical case. RESULTS: Ninety-two percent (53/64) of PEM directors and 64% (64/100) of EM directors responded (overall response rate 74%). Compliance with the guidelines (PEM/EM) was 54%/16% for case 1, 31%/6% for case 2, 35%/19% for case 3, and 20%/11% for case 4. Only 11% of PEM and 2% of EM directors followed the guidelines for all four cases. Overall, directors performed fewer laboratory tests, ordered more chest radiographs and treated fewer patients with antibiotics than the expert panel suggested. EM directors ordered more chest radiographs (cases 1-4) and admitted more patients (case 2) than PEM directors. CONCLUSIONS: There is poor compliance with published practice guidelines in the management of febrile infants and children among PEM and EM directors. |
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Authors:
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R A Belfer; M A Gittelman; A E Muñiz |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Pediatric emergency care Volume: 17 ISSN: 0749-5161 ISO Abbreviation: Pediatr Emerg Care Publication Date: 2001 Apr |
Date Detail:
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Created Date: 2001-05-03 Completed Date: 2001-09-13 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8507560 Medline TA: Pediatr Emerg Care Country: United States |
Other Details:
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Languages: eng Pagination: 83-7 Citation Subset: IM |
Affiliation:
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Department of Pediatric Emergency Medicine, Cooper Health Care System, Camden, New Jersey, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Anti-Bacterial Agents / administration & dosage Bacterial Infections / complications, diagnosis* Canada Emergency Medicine / standards* Fellowships and Scholarships / organization & administration Fever / etiology, metabolism, radiography, therapy* Guideline Adherence / statistics & numerical data* Hospitalization Humans Infant Infant, Newborn Internship and Residency / organization & administration Laboratory Techniques and Procedures / utilization Pediatrics / standards* Physician Executives / standards* Practice Guidelines as Topic* Radiography, Thoracic / utilization United States |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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