Pediatría Atención Primaria
Print version ISSN 1139-7632
GARCIA PUGA, J. M. et al. Analysis of pediatricians´ and residents´ knowledge of fever management in relation to established guidelines. Rev Pediatr Aten Primaria [online]. 2012, vol.14, n.54, pp.115-126. ISSN 1139-7632. http://dx.doi.org/10.4321/S1139-76322012000300004.
Objective: to evaluate the advice given to parents about fever, determine the incidence of Fever Without Source (FWS) in the pediatrician´s office, availability of complementary examinations (CE) and the implementation of fever guidelines (FG). Methods: questionnaires distributed to 151 Primary Attention Pediatricians (PAP), Hospital Pediatricians (HP) and Residents (R). Statistical analysis SPSS 15.0. For qualitative variables the X2 test was used. Significant value was p < 0.05. Results: 109 questionnaires analyzed: women 65.4% and men 34.6%. 44.9% defined fever 37.5 oC axilar temperature and 38 oC rectal temperature. 78.9% advise the use of electronic thermometer, 93.6% advice taking non-drug measures, 79.8% choose paracetamol and 76.1% alternate antipyretics in selected cases. 56.2% diagnosed 10% of FWS per week, 19.3% always encode it, 31.2% sometimes and 45.9% never. For infants < 6 m are required: 91.7% urine strips, 41.3% urine culture; from 6-12 months: 96.3% urine strips and 11.9% urine culture. PAP receive results the same day: CBC count 3%, radiology 68.6% and urine culture in less than 72h, 38.7%. HP and R the same day, CBC 83.3% and Rx 85.7% and urine cultures 85.7% in less than 72 hours. Infants from 1-3 months with FWS are sent to hospital by PAP 74.6% and HP 64.7% and 83.3% of residents ask for CE. 78.9% know the FG, 69.8% believe them applicable, and 65.4% apply them. Conclusions: in majority of cases it is recommended to use electronic thermometers, take non-drug measures and use paracetamol. Selected alternation of antipyretics. Underdiagnosis of FSF. Limited access to complementary exams by PAP. High awareness but low FG implementation.
Keywords : Fever; Fever without source; Questionnaires; Child; Internship and Residency.