Paediatric Fever Management Practices and Antipyretic Use Among Doctors and Nurses in Australian Emergency Departments
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To examine variation in practice and adherence to international clinical guidelines for the management of fever among Australian Emergency Department (ED) clinicians. METHODS: Cross-sectional survey across 22 Australian EDs. Clinical vignettes were used to determine compliance with international best practice guidelines (use of antipyretic monotherapy to alleviate fever-associated child distress) for paediatric fever treatment. Comparisons were made between specialist paediatric EDs and general (non-specialist paediatric) EDs, and between medical and nursing staff. RESULTS: Of 539 survey respondents (300 doctors, 239 nurses; overall response rate 65.9%), only 9.3% (50/539, 95% confidence interval [CI] 7.1%-12.0%) adhered to evidence-based practice guidelines. Specialist paediatric ED clinicians demonstrated less than half the adherence of those from general EDs (5.4% [11/204] vs. 12.4% [38/307], difference -7.0%, 95% CI -11.7% to -1.9%). In a febrile settled child with normal hydration, the proportion of respondents who opted for antipyretics more than doubled in the context of elevated vital signs (40.4% [218/539] vs. 83.1% [44/539], difference -42.7%, 95% CI -46.8% to -38.2%). Nearly half of respondents (239/539, 46.8%, 95% CI 42.4%-51.2%) endorsed giving combined antipyretic therapy. In a febrile settled child, most participants would give antipyretics for temperature reduction (453/539, 84.0%, 95% CI 80.7%-86.9%) and for decreased fluid intake (468/539, 87.5%, 95% CI 84.4%-90.0%). Over one-third (192/539, 36.0%, 95% CI 32.1%-40.2%) recommended using antipyretics for febrile convulsion prevention during the current illness. CONCLUSIONS: Fewer than 10% of Australian ED clinicians self-report practice consistent with international consensus recommendations for paediatric fever management.
Source: Emergency Medicine Australasia
Authors: Anastasia Mutic, Rui Zhi Tan, Eunicia Tan, Michael C. Fahey, Emily Callander, Libby Haskell, Shane George, Meredith L. Borland, Naomi Loftus, Jeremy Furyk, Natalie Phillips, Jane Bourke, Stuart R. Dalziel, Simon Craig, the PREDICT Network
Institutions: Monash University, University of Auckland, Middlemore Hospital, Monash Health, University of Technology Sydney, Starship Children's Health, Griffith University, The University of Queensland, Gold Coast Hospital, Gold Coast Health, The University of Western Australia, Princess Margaret Hospital for Children, Perth Children's Hospital, Monash Medical Centre, Barwon Health, Deakin University, Geelong Hospital, Children's Health Queensland Hospital and Health Service
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,750
OpenAlex ID: W4415788947