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