Parents Often Right to Bring Kids With Fever to the ER: Study

TUESDAY, Feb. 28 (HealthDay News) — Many parents who bring their
children to the emergency room with fevers are making the right decision,
Dutch investigators report.

“Self-referred febrile [feverish] children should not be generalized,
and therefore not approached, as a uniform group of non-severely ill
patients,” said lead researcher Dr. Yvette van Ierland, from the
department of pediatrics at Sophia Children’s Hospital/Erasmus University
Medical Center in Rotterdam.

“Measures to discourage parents from self-referral are undesirable,”
she added. “This may potentially result in delayed or missed
diagnoses.”

In general, illnesses that are associated with a fever for which early
diagnosis is important are serious bacterial infections, such as
meningitis, bacteremia, urinary tract infections or pneumonia, Ierland
said.

The researchers found that one in four parents properly judged and
acted on their child’s illness by going to the emergency room, Ierland
said.

The report is published in the March issue of Pediatrics.

To see if parents’ judgments were on target, Ierland’s team compared
children with fevers referred to emergency rooms by doctors to children
who were brought in by their parents.

Of more than 4,600 children under the age of 16 with fever included in
the study, 38 percent were referred by general practitioners and 62
percent by parents.

Among the children referred by doctors, 46 percent were classified as
needing urgent care, compared with 45 percent of the children taken in by
a parent, the researchers found.

In addition, 43 percent of children referred by doctors needed
extensive treatment such as intravenous medications, asthma treatment or
were hospitalized, compared with 27 percent of the children parents
brought in for care, they noted.

Children who needed urgent care, such as those with difficulty
breathing, stomach problems, neurological problems or fever with no known
reason, were referred equally by doctors and parents, they added.

However, Dr. Roya Samuels, a pediatrician at Cohen Children’s Medical
Center in New Hyde Park, N.Y., doesn’t think the situation necessarily
applies to the United States.

“I would take the results of this study with a grain of salt,” she
said. Perhaps parents in the Netherlands are better educated about the
signs of serious illness in their children in the United States, she
noted.

“Here a lot of parents bring in their children for a simple cold with
fever that could very easily be handled over the phone by a medical
professional,” Samuels said.

If parents would call their doctor before deciding to take their child
to the hospital “we could save parents a lot of trouble and time going to
the emergency room for unnecessary visits,” she added.

However, doctors should not discount parent’s assessment of their
child, Samuels stressed.

Some parents might overreact to a simple illness with fever, she said.
“But parents have a sixth sense when it comes to their own children, and
physicians need to take that seriously,” she added.

Fever is the way the body fights off a viral illness, and most of the
time the child does not need to go to an emergency room, Samuels said. “No
intervention is needed unless there are other telltale signs that this
could be a bacterial infection. We look for other more worrisome signs
that accompany the fever.”

Signs that an illness might be serious include whether the child with a
fever is not as active as usual or not eating or drinking. “That’s
concerning to us,” Samuels said.

“If there is any trouble breathing, if there is any dehydration, those
would be immediate red flags for me,” she said. “Duration of fever is
another important factor. If a child has had fever over three to five days
that child should be seen.”

More information

For more on fever in children, visit the U.S. National Library of Medicine.

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