18 | Febrile Neonate with Dr Lindsay McHale

In this episode of PEM CHATT, the focus is on febrile neonates, the first part of a two-part series on pediatric fever management. Host Toni speaks with Dr. Lindsay McHale, a pediatric emergency medicine physician, to discuss how historical protocols for managing febrile neonates have evolved with advances in vaccines, PCR testing, and maternal surveillance. The discussion covers the 2021 AAP guidelines for managing febrile neonates, the essential components of a fever workup, interpretation of test results, and the nuances of decision-making across neonatal age groups. Practical insights on performing lumbar punctures, antibiotic selection, and interpreting potentially confounding results, such as bloody CSF taps, are shared, along with real-life case examples that illustrate the complexities involved. The conversation aims to equip clinicians with an evidence-based approach to improve patient outcomes in various clinical settings.

#PEM #NP #APP #PA #pediatrics #emergencymedicine #emergencynursepractitioner #fellowship #medicaleducation #podcast #children #nursepractitioner #clinicalpharmacists #febrileneonate #sickbabies #lumbarpuncture

00:00 Introduction to Febrile Neonates

00:57 Historical Management of Febrile Neonates

01:25 Advancements in Medicine and New Guidelines

02:23 Introducing Dr. Lindsay McHale

03:56 Defining Febrile Neonates

04:54 Managing Febrile Neonates in the ER

05:51 Cold Babies and Controversies

07:45 Treating Fever in Neonates

09:06 Inclusion and Exclusion Criteria for Febrile Neonate Protocol

10:27 Why Neonates Are High-Risk

11:40 Code 60: Rapid Response for Febrile Neonates

12:30 Hypothetical Case Study: Febrile Neonate

14:24 Parental Concerns and Communication

19:57 Detailed Workup and Testing

23:27 Antibiotic Choices for Neonates

25:13 Dosing Nuances in Neonatal Antibiotics

26:49 Tips for Performing Lumbar Punctures

30:25 Interpreting Test Results in Neonates

32:46 AAP Sepsis Protocol for Neonates

40:06 Managing Febrile Infants: Case Studies

44:18 Conclusion and Next Episode Preview

LINKS:

AAP Guideline https://publications.aap.org/pediatrics/article/148/2/e2021052228/179783/Evaluation-and-Management-of-Well-Appearing?autologincheck=redirected

CHOP Algorithm

https://www.chop.edu/clinical-pathway/febrile-infant-emergent-evaluation-clinical-pathway

THE MISFITS

https://drive.google.com/file/d/1gpUsQOxMlbuqI-6hBDcZEF5ckpJWhWWb/view?usp=sharing