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NICE sets out standards for treating unexplained fever in children

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Improvements are needed in the care of children with unexplained fever, according to the National Institute for Health and Care Excellence.

Two-fifths of youngsters are taken to primary care because they are running a fever. In many cases it is caused by a viral infection which will go away on its own but NICE noted that in some cases it is a sign of meningitis or pneumonia.

The institute has set out a new quality standard for health professionals highlighting where improvements are most needed in the care of children running a fever.

“The standard encourages healthcare professionals to use the ‘traffic light system’ which may help pick up high-risk symptoms earlier”

Andrew Riordan

It includes four statements aimed at healthcare professionals, particularly those working in general practice and emergency departments.

The quality standard tates that any under-fives with suspected fever who are seen by a healthcare worker should have their vital signs checked.

Clinicians should also assess the child’s risk of a serious illness using a “traffic light system” which helps pick up high-risk symptoms early on.

If a case can be treated at home parents and carers should be given advice about how to care for their child and told when to seek help if the condition deteriorates.

They should be advised to keep their youngster away from school or nursery, give them plenty of fluids and check them regularly through the day and night.

They should also be made aware of danger signs, such as a rash which does not disappear or if the condition deteriorates, which could indicate they need to seek further medical attention, the standard states.

“In many cases fever is caused by a viral infection and children will recover quickly without treatment,” said Professor Gillian Leng, deputy chief executive at NICE.

“However, in some cases it can be the first sign of a more serious bacterial illness such as meningitis or pneumonia.

Gillian Leng

“This new quality standard sets out clear priorities that will help doctors, nurses, pharmacists and other healthcare professionals pick up the high-risk symptoms that indicate a child needs urgent medical attention.”

Dr Andrew Riordan, consultant at Alder Hey Children’s NHS Foundation Trust in Liverpool, added: “Identifying the cause of fever can be very difficult, particularly in very young children, and some children can deteriorate very quickly.

“The standard encourages healthcare professionals to use the ‘traffic light system’ which may help pick up high-risk symptoms earlier and potentially prevent long-term harm. We hope this quality standard will improve the assessment of young children with unexplained fever.”

Christopher Head, chief executive at the Meningitis Research Foundation, added: “Meningitis and septicaemia become life-threatening within hours of the onset of fever, so identification and treatment are time-critical.

“We believe the new NICE quality standard to identify and treat under-fives seriously ill with fever will ensure that commissioners and health professionals have the information they need to deliver the best care for these children.”



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  • What is this traffic light system then?

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