- Look for the red flags – hypotension, environmental exposures, medications (SS, NMS), SIRS/qSOFA criteria
- Be on the lookout for neutropenic fever – isolate patients, administer abx early, and admit
- Sepsis definition is changing all the time – be aware of current guidelines
- Remove pre-existing indwelling lines/catheters in the setting of sepsis – its all about source control
- Temporal/oral temps are unreliable! Check a rectal temp if no contraindication
- Old patients don’t necessarily present with all SIRS criteria – be aware of patients on beta blockers
- Immunocompromised patients – lower threshold for empiric abx and admission
- Never discharge abnormal VS – no fever and persistent tachycardia my be a sign of badness (myocarditis)
- Rule of thumb is 1 degree F will increase pulse by 10 BPM – look for pulse temperature dissociation
REBEL Core Cast – Basics of EM – Fever
Click here for Direct Download of the Podcast
Co-Host
Elias Wan, MD, FAAEM
Clinical Assistant Professor of Emergency Medicine at SUNY Downstate School of Medicine
Maimonides Medical Center
City/State: Brooklyn, NY
Email: eliaswan@gmail.com
Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)
Cite this article as: Ellsworth Wright, "REBEL Core Cast – Basics of EM – Fever", REBEL EM blog, June 1, 2022. Available at: https://rebelem.com/rebel-core-cast-basics-of-em-fever/.
