Peds “step by step”(for FWS)

27 Feb

submitted by Amit Kumar, M.D.


“Step by Step”

-Algorithm to identify pediatric patients (<90 days) with fever without a source (38°C, in patients with a normal PE and no respiratory symptoms or a diarrheal process) as low risk for invasive bacterial infection

-Developed by European group of EPs, validated

-Identifies “low risk” group not requiring LP and empiric antibiotics, and fit to be managed outpatient

-Found to be more sensitive than Rochester Criteria and Lab-score


(Pediatric Assessment Triangle = appearance, work of breathing, circulation)

(PCT = procalcitonin)

-There, add it to your toolbox!

Gomez, B., Mintegi, S., Bressan, S., Dalt, L. D., Gervaix, A., & Lacroix, L. (2016). Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants. Pediatrics, 138(2). doi:10.1542/peds.2015-4381

Pediatric assessment triangle article


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