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/pediatri...
CHOP Algorithm
https://www.chop.edu/clinical-pathway...
THE MISFITS
https://drive.google.com/file/d/1gpUs...