Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Triage guideline for immunocompromised children with fever in an emergency centre in Ethiopia

Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Triage guideline for immunocompromised children with fever in an emergency centre in Ethiopia

International
Pediatrics
Sepsis

Fever in children with neutropenia often portends life-threatening bacteremia that may be ameliorated with
early recognition and the rapid administration of antimicrobial therapy. Studies demonstrating this effect have
been done in resource-endowed countries, but not in resource-limited settings. We attempted to decrease the
time to antibiotics in patients with fever and neutropenia presenting to a paediatric emergency centre at a
tertiary care referral hospital in Ethiopia. In 3 phases we performed baseline data collection, instituted triaging
and treatment guidelines, and provided antibiotics. We tracked a variety of outcomes, most importantly time
from arrival to initiation of antibiotics. While this time was reduced during the guideline institution phase of our
intervention, time reductions were inconsistent and not sustained. This was likely due to competing clinical
priorities among providers caring for a high volume of ill children. While in the U.S., fever and neutropenia is
easy to prioritise within the paediatric emergency centre, future quality improvement measures in this setting
may have a greater benefit on critical presentations such as shock or respiratory failure. Alternative strategies
geared towards general efficiency improvement and teamwork, rather than focusing on one patient group may be
a higher yield approach for improving care in this paediatric emergency centre.

Workeabeba Abebe , Tigist Bacha , Andi L. Shane , Tal Berkowitz

www.elsevier.com/locate/afjem

elsevier

11 October 2020

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