Junior doctor survival kit
You’ve been bleeped: patient with a fever
- By: Lucie Weatherall, James Bonnington, Andrew Clarke
Patients with a fever on the ward might have been admitted with infection that is not improving or admitted for another reason and developed a hospital acquired infection. An infection is not the only differential for a patient with fever so keep an open diagnostic mind. Whatever the cause of the patient’s fever, a high temperature is often the first presentation of a serious illness or serious deterioration so you need to be adept with your clinical assessment and speedy when instigating an initial management plan.
Bleeps about fever can be difficult because, as an isolated sign, it does little to describe the patient’s physiology. Furthermore, sepsis can evolve with time.
As the FY1 on call your priority is to identify the severity of a patient’s illness. You can use several helpful structures to make this assessment, and there are recognised guidelines to follow. You should realise your limitations in