@article {Monteny:1 April 2008:0960-1643:242, author = "Monteny, Miriam", author = "Berger, Marjolein Y", author = "van der Wouden, Johannes C", author = "Broekman, Berth J", author = "Koes, Bart W", title = "Triage of febrile children at a GP cooperative: determinants of a consultation", journal = "British Journal of General Practice", volume = "58", year = "1 April 2008", abstract = "Background

Most febrile children contacting a GP cooperative are seen by a GP, although the incidence of serious illness is low. The guidelines for triage might not be suitable in primary care.

Aim

To investigate the determinants related to the outcome of triage in febrile children.

Design of study

Cross-sectional study.

Setting

Dutch GP cooperative.

Method

Receptionists filled out a triage questionnaire when parents called regarding their febrile child (aged between 3 months and 6 years) and estimated the level of concern of the parents. The outcome was either telephone advice, a consultation, or a home visit. Children were divided in subgroups based on age <18 months or ≥18 months, and prognostic models for a consultation were constructed.

Results

Of 422 children, 73% were seen by a GP. Children aged <18 months were more likely to be seen when their parents reported less drinking or shortness of breath. In children aged ≥18 months, a duration of fever of ≥3 days, drowsiness, or a pale, ashen, or mottled skin were predictors of consultation. Children with alarm symptoms were seen according to the guideline. In both subgroups, children without alarm symptoms were more likely to be seen when their parents were concerned.

Conclusion

The available guideline was followed to a large extent at a GP cooperative. Because, surprisingly, most children were reported to have alarm symptoms, the validity of the triage questions asking parents about alarm symptoms is questionable.", pages = "242-247(6)", url = "http://www.ingentaconnect.com/content/rcgp/bjgp/2008/00000058/00000549/art00007" doi = "doi:10.3399/bjgp08X279643" }