On Clinical Decision Making and Evidence Based Medicine - Assignment Example

Evidence- Based Practice Problem: 5 year old Joe was brought to the emergency department with complaints of fever since 4 hours. He also had mild running nose. He had no other symptoms. On examination, Joe was active, alert and playful. Temperature was 101 degree F. Ears and throat examination was normal. Systemic examination also was normal. Joes temperature needs to be brought down.
Question: In children with uncomplicated fever, whether antipyretics or environmental measures is the best to bring down temperature.
Type of question: Intervention
Ideal study type: Randomized control study or systematic review or best practice guidelines
P Bringing down temperature in children with uncomplicated fever
I Anti-pyretics
C Environmental methods
O Subsidence of fever with treatment and no complications arising
References used:
1. Barclay, L.,2007. Best Management of Fever from an Unidentifiable Source in Young Children. Retrieved on June 6, 2009 from http://www.medscape.com/viewarticle/558964 (Best practice guidelines)
2. Overland, K.D. and Carter, C. (2007). Nursing Management of Fever in Children. Journal of Pediatric Nursing, Volume 22, Issue 2, Pages 147-148 (Systematic review)
3. Watts R, Robertson J, Thomas G. (2003). Nursing management of fever in children: a systematic review. Int J Nurs Pract. 2003 Feb;9(1):S1-8 (Systematic review)
Answer: Fever can be brought down with antipyretic or environmental methods. Of these paracetamol and tepid sponging are the most effective with least side effects. Most of the studies report that paracetamol is more effective than sponging especially in temperate climates. A combination of both may also be used. Read More