Diagnosis and treatment of pediatric fever by caretakers

Assessment of pediatric temperature is a multistep task involving both mani pulative and cognitive skills, Emergency Physicians typically assume that p arents possess these skills, but this assumption has never been fully teste d, A prospective survey was conducted of caretakers of children less than o r equal to 36 months of age presenting to an inner city emergency departmen t or pediatric clinic, Participants were asked to read a Fahrenheit scale m ercury thermometer and to demonstrate use of that thermometer to "take" the temperature of an infant doll. They were then asked what temperature const ituted a "fever" and what temperature would require antipyretic therapy, Ca retakers were also asked how they would treat a fever in the child they had brought for treatment. Proportions of correct responses were tabulated and also compared by age and level of education of caretaker. Eighty-two of 92 caretakers (89.1%) possessed working thermometers in their homes. Thirty-s ix subjects (39.1%) were able to measure temperature appropriately using th e mercury thermometer, 52 (56.5%) were able to read the mercury thermometer correctly, and 28 (30.4%) could both measure and read correctly. Sixty-sev en subjects (72.8%) described correct treatment of fever. Overall, 27 subje cts (29.3%) could measure, read, and treat fever appropriately. There was n o statistically significant difference in age or percentage of high school graduates between caretakers who could successfully measure, read and treat and those who could not. In this inner city patient population, caretakers of any pediatric patient whose discharge instructions contain a reference to patient temperature should receive a brief refresher along with written instructions on temperature measurement and treatment. (C) 2000 Elsevier Sc ience Inc.