REBEL Core Cast – Basics of EM – Fever

Take Home Points

  • 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/.

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