Linee guida
Valutazione e gestione iniziale della malattia febbrile nei bambini di età inferiore ai 5 anni secondo un sistema a semaforo
ASSESSMENT AND INITIAL MANAGEMENT OF A FEVERISH ILLNESS IN CHILDREN YOUNGER THAN 5 YEARS ACCORDING TO A TRAFFIC LIGHT SYSTEM
FEDERICO MARCHETTI, GIANLUCA TORNESE, FRANCO PANIZON*
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
*Professore Emerito, Dipartimento di Scienze della Riproduzione e dello Sviluppo, Università di Trieste
Febbraio 2008 - pagg. 95 -102
Abstract
Fever in young children usually indicates an underlying infection, but identifying the cause can pose a diagnostic challenge. In the absence of guidance, feverish illness is variably assessed and managed by paediatricians. In May 2007, the National Institute for Health and Clinical Excellence (NICE) published the most recent guideline about assessment and initial treatment of children aged under 5 years with fever, based on a intuitive traffic light system. This guideline is based on systematic reviews of best available evidence and when minimal evidences were available, a range of consensus techniques was used to develop recommendations. This article aims at summarising this guidance from NICE and at proposing a practical care pathway for remote, face-to-face and hospital assessment and management of feverish children.
Parole chiave
Classificazione MeSH
Bibliografia
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16. Fontana M, Federico P, Cantucci S. Il ricovero pediatrico in Lombardia: cause, variabilità e possibile inappropriatezza. Medico e Bambino 2007;26(8):520-6.
2. McCarthy PL. Fever. Pediatr Rev 1998;19: 401-7.
3. Baker MD. Evaluation and management of infants with fever. Pediatr Clin North Am 1999;46:1061-72.
4. Kramer MS, Shapiro ED. Management of the young febrile child: a commentary on recent practice guidelines. Pediatrics 1997;100: 128-34.
5. Slater M, Krug SE. Evaluation of the infant with fever without source: an evidence based approach. Emerg Med Clin North Am 1999; 17:97-126.
6. Baraff LJ. Management of fever without source in infants and children. Ann Emerg Med 2000;36:602-14.
7. National Institute for Health and Clinical Excellence. Feverish illness: assessment and initial management in children younger than 5 years. London: NICE; 2007. www.nice.org. uk/CG047.
8. Richardson M, Lakhanpaul M, Guideline Development Group and the Technical Team. Assessment and initial management of feverish illness in children younger than 5 years: summary of NICE guidance. BMJ 2007;334(7604): 1163-4.
9. Rabusin M, Ronfani L, Tamburlini G. La febbre nei primi 3 mesi di vita. Medico e Bambino 1994;13(8):451-6.
10. Russian S, Salvatore CM. La febbre alta nel lattante e nel bambino sotto i tre anni. Medico e Bambino 1997;16(3):171-5.
11. Fontana M, Capizzi M, Stringhi C. Il lattante febbrile: analisi delle linee guida. Medico e Bambino 2002;21(7):449-52.
12. Fontana M. Lattante febbrile, sicurezza, errore, qualità. Medico e Bambino 2002;21(7): 416-7.
13. Steiner MJ, DeWalt DA, Byerley JS. Is this child dehydrated? JAMA 2004;291(22):2746-54.
14. Reggiani L. Self help e percorso diagnostico di una febbre da causa sconosciuta. Medico e Bambino 2007;26(6):370-4.
15. Guglia E, Marchi AG, Bassanese S, Norbedo S, Messi G. Osservazione temporanea: ruolo e prospettive tra Ospedale e territorio. Medico e Bambino 2004;23(9):567-70.
16. Fontana M, Federico P, Cantucci S. Il ricovero pediatrico in Lombardia: cause, variabilità e possibile inappropriatezza. Medico e Bambino 2007;26(8):520-6.
Corrispondenza: marchetti@burlo.trieste.it