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Consensus guidelines on evaluation and management of the febrile child presenting to the emergency department in India

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Abstract

Justification

India, home to almost 1.5 billion people, is in need of a country-specific, evidence-based, consensus approach for the emergency department (ED) evaluation and management of the febrile child.

Process

We held two consensus meetings, performed an exhaustive literature review, and held ongoing web-based discussions to arrive at a formal consensus on the proposed evaluation and management algorithm. The first meeting was held in Delhi in October 2015, under the auspices of Pediatric Emergency Medicine (PEM) Section of Academic College of Emergency Experts in India (ACEE-INDIA); and the second meeting was conducted at Pune during Emergency Medical Pediatrics and Recent Trends (EMPART 2016) in March 2016. The second meeting was followed with futher e-mail-based discussions to arrive at a formal consensus on the proposed algorithm.

Objective

To develop an algorithmic approach for the evaluation and management of the febrile child that can be easily applied in the context of emergency care and modified based on local epidemiology and practice standards.

Recommendations

We created an algorithm that can assist the clinician in the evaluation and management of the febrile child presenting to the ED, contextualized to health care in India. This guideline includes the following key components: triage and the timely assessment; evaluation; and patient disposition from the ED. We urge the development and creation of a robust data repository of minimal standard data elements. This would provide a systematic measurement of the care processes and patient outcomes, and a better understanding of various etiologies of febrile illnesses in India; both of which can be used to further modify the proposed approach and algorithm.

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Authors and Affiliations

  1. Departments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, MI, USA

    Prashant Mahajan

  2. Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India

    Prerna Batra & Dheeraj Shah

  3. Department of Pediatrics, Hind Institute of Medical Sciences, Lucknow, India

    Neha Thakur

  4. Department of Pediatrics, Division of Inpatient Medicine, University of Utah, Salt Lake City, UT, USA

    Reena Patel

  5. Department of Pediatrics, Hind Institute of Medical Sciences, Lucknow, India

    Narendra Rai

  6. Department of Pediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur, India

    Nitin Trivedi

  7. Department of Pediatrics; Division of Inpatient Medicine and Department of Epidemiology and Biostatistics, University of Utah, Salt Lake City, UT, USA

    Bernhard Fassl

  8. Departments of Emergency Medicine and Pediatrics, SUNY Downstate Medical Center, Kings County Hospital Center, Brooklyn, NY, USA

    Binita Shah

  9. Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA

    Marie Lozon & Rockerfeller A. Oteng

  10. Directorate of Emergency Medicine, KomfoAnokye Teaching Hospital, Kumasi, Ghana

    Rockerfeller A. Oteng

  11. Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India

    Abhijeet Saha

  12. Department of Emergency Medicine, University of Florida, Jacksonville, FL, USA

    Sagar Galwankar

  13. CS Mott Children’s Hospital, University of Michigan, 1540 East Hospital drive, Room 2-737, SPC 4260, Ann Arbor, MI, 48109-4260, USA

    Prashant Mahajan

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  1. Prashant Mahajan
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  2. Prerna Batra
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  8. Binita Shah
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  9. Marie Lozon
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  11. Abhijeet Saha
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  12. Dheeraj Shah
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  13. Sagar Galwankar
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Consortia

Academic College of Emergency Experts in India (ACEE-INDIA) – INDO US Emergency and Trauma Collaborative

Corresponding author

Correspondence to Prashant Mahajan.

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Mahajan, P., Batra, P., Thakur, N. et al. Consensus guidelines on evaluation and management of the febrile child presenting to the emergency department in India. Indian Pediatr 54, 652–660 (2017). https://doi.org/10.1007/s13312-017-1129-8

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  • DOI: https://doi.org/10.1007/s13312-017-1129-8

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