Febrile Children Self-Referred to ER Usually Less Severely Ill
(HealthDay News) – In 45% of self-referred cases, parents properly judge their child's febrile illness as urgent when they bring their child to the emergency department, according to a study published online Feb. 27 in Pediatrics.
Yvette van Ierland, MD, from MC/Sophia Children's Hospital in Rotterdam, Netherlands, and colleagues conducted an observational study of 4,609 children (aged <16 years) with fever who presented to the emergency department, as general practitioner (GP)-referred or self-referred patients. Markers for severity of illness were urgency according to the Manchester Triage System, diagnostic interventions, therapeutic interventions, and follow-up.
The researchers found that 38% of the febrile children were referred by their GP and 62% were self-referred. Forty-six percent of GP-referred children were classified as high urgency (immediate/very urgent categories) cases, compared with 45% of self-referrals. Forty-three percent of GP referrals and 27% of self-referrals needed extensive diagnostic intervention, intravenous medication/aerosol treatment, hospitalization, or a combination of these (odds ratio, 2). In all subgroups, high urgency was not associated with referral type. GP-referred and self-referred children with dyspnea had similar frequencies of illness-severity markers.
"Although febrile self-referred children were less severely ill than GP-referred children, many parents properly judged and acted on the severity of their child's illness," the authors write.