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Pharmacy World and Science

, Volume 27, Issue 3, pp 254–257 | Cite as

When Fever, Paracetamol? Theory and Practice in a Paediatric Outpatient Clinic

  • Mario GehriEmail author
  • Emmanuèle Guignard
  • Samira Radji Djahnine
  • Jocelyne Quillet Cotting
  • Corinne Yersin
  • Ermindo R. Di. Paolo
  • Jean-Daniel Krahenbuhl
  • André Pannatier
Article

Abstract

Objective: To determine how medical and nursing staff treat feverish children and compare the findings with their theoretical knowledge, evaluating how they might contribute to fever phobia in parents.

Setting: Paediatric Emergency Department.

Method: In the first step, we analysed prospectively the files of all children having consulted the Paediatric Emergency Department with a history of fever or of body temperature above 38 °C during a 2-week period. The second step consisted of evaluating knowledge and perception of fever of doctors and nurses using a questionnaire.

Main outcome measures: Prospective study: final diagnosis (viral, non- invasive bacterial disorders, invasive bacterial disorders), site of measurement and average temperature. Evaluation of theoretical knowledge: definition of fever, site of measurement, evaluation of the child’s clinical state, antipyretic drug choice.

Results: A total of 114 children under 5 years of age were enrolled and 24 caregivers (12 doctors, 12 nurses, 90 of the staff) responded to the questionnaire. The results showed good consistency in theoretical knowledge, but an excessive fear about cerebral damage was also shown by doctors. This belief likely contributes to the transmission of fever phobia to parents. In contrast, analysis of children management showed that fever was often under-treated, especially by nurses and even more so by parents. Paracetamol remained the first-line antipyretic drug yet was often administered in insufficient doses. Non-steroidal anti-inflammatory drugs were seldom used, except by parents (16 of all the children). Contrary to literature, the favourite route of administration was the rectal one. Physical methods like sponging were largely used by nurses, despite the uncertainties in their real effectiveness and their known side-effects.

Conclusion: Our study showed that the management of feverish children was globally correct in the Paediatric Emergency Department, but several improvement measures have been taken (e.g. tables of normal and abnormal ranges of temperature, recommended temperature measurement techniques, dosage regimen of antipyretic drugs, guidelines to parents), justifying the implementation of a pharmaceutical follow-up.

Keywords

Fever Paracetamol Pediatrics Pharmacotherapy Switzerland 

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Copyright information

© Springer 2005

Authors and Affiliations

  • Mario Gehri
    • 1
    • 2
    Email author
  • Emmanuèle Guignard
    • 3
  • Samira Radji Djahnine
    • 3
  • Jocelyne Quillet Cotting
    • 2
  • Corinne Yersin
    • 2
  • Ermindo R. Di. Paolo
    • 3
  • Jean-Daniel Krahenbuhl
    • 2
  • André Pannatier
    • 3
  1. 1.Hôpital de l’Enfance de LausanneLausanne 7Switzerland
  2. 2.Department of PaediatricsUniversity Hospital (CHUV)LausanneSwitzerland
  3. 3.LausanneSwitzerland

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