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GP Vivaschild-and-youth-health

GP Vivas · child-and-youth-health

Fever in children — structured viva

Structured oral on the febrile child: defending the traffic-light system with its validated limits, the under-3-month rule, antipyretic evidence against fever phobia, febrile seizure evaluation, and the safety net that makes discharge defensible.

structured clinical oral4 min readVerification in progress

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
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Study tools

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Your practice still tells parents to alternate paracetamol and ibuprofen round-the-clock and to sponge children. Defend or dismantle that advice — and then tell me how you decide which febrile child goes to hospital.' The viva branches through risk stratification, age thresholds, antipyresis, seizures and discharge.

Stem

You are the GP. A colleague hands out a practice leaflet advising alternating paracetamol and ibuprofen every four hours around the clock plus tepid sponging for any childhood fever. [38] [12]

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References10ShowHide
  1. [3]Van den Bruel A, Haj-Hassan T, Thompson M, et al. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: a systematic review. Lancet, 2010.PMID 20132979
  2. [5]Thompson M, Coad N, Harnden A, et al. How well do vital signs identify children with serious infections in paediatric emergency care? Archives of Disease in Childhood, 2009.PMID 19608555
  3. [7]Kerkhof E, Lakhanpaul M, Ray S, et al. The predictive value of the NICE red traffic lights in acutely ill children. PLoS One, 2014.PMID 24633015
  4. [12]Wong T, Stang AS, Ganshorn H, et al. Combined and alternating paracetamol and ibuprofen therapy for febrile children. Cochrane Database of Systematic Reviews, 2013.PMID 24174375
  5. [14]Meremikwu M, Oyo-Ita A Physical methods for treating fever in children. Cochrane Database of Systematic Reviews, 2003.PMID 12804512
  6. [16]Subcommittee on Febrile Seizures, American Academy of Pediatrics Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics, 2011.PMID 21285335
  7. [17]Offringa M, Newton R, Nevitt SJ, et al. Prophylactic drug management for febrile seizures in children. Cochrane Database of Systematic Reviews, 2021.PMID 34131913
  8. [19]Schmitt BD Fever phobia: misconceptions of parents about fevers. American Journal of Diseases of Children, 1980.PMID 7352443
  9. [20]Crocetti M, Moghbeli N, Serwint J Fever phobia revisited: have parental misconceptions about fever changed in 20 years? Pediatrics, 2001.PMID 11389237
  10. [38]Fields E, Chard J, Murphy MS, et al. Assessment and initial management of feverish illness in children younger than 5 years: summary of updated NICE guidance. BMJ, 2013.PMID 23697671
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