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Medical

FEVER

Signs and Symptoms: Differential Diagnosis:
• Warm • Infection/Sepsis
• Flushed • Cancer/Tumor/Lymphoma
• Diaphoretic • Medication/Drug Reaction
• Chills • Connective Tissue Diseases
Associated Symptoms: • Hyperthyroidism
• Myalgias, Cough, Chest Pain, • Heat Stroke
Headache, Dysuria, Abdominal • Meningitis
Pain, Mental Status Change,
Rash, Stiff Neck
Universal Patient Care Guideline
Continued from: O2 (if Hypoxemic)
Tactical Evacuation Guidelines IV/IO Guideline (prn)
Cardiac Monitor (prn)

Consider Droplet, Airborne, or
Contact Precautions
(*See Pearls)
Consider:
Hyperthermia Guideline
1000mL IVF IV prn
(repeat as needed) YES Orthostatic BP/Tachycardia? Toxic Ingestion Guideline
NO
2L IVF and still Hypotensive? Encourage PO Intake if
Consider: Protecting Airway
Norepinephrine Acetaminophen 1g PO
2-12mcg/min IV (if not provided in last 6 hours)
>38ºC (100.4ºF)
Temperature?
<38ºC (100.4ºF)
Consider:
Sepsis Guideline Return to:
Tactical Evacuation Guideline
Or Appropriate Guideline by Complaint
Pearls:
• Fever may not be present in immunocompromised, elderly, or those on immunosuppressive drugs.
• All fever is not due to infection–evaluate for environmental/thyroid/toxic etiology.
• *Appropriate precautions should be used for personal protection when transporting patients with
contagious disease:
o Airborne: standard PPE plus N-95 mask and NRB or surgical mask on patient. Used for
tuberculosis, measles, varicella, or other infections spread by droplets.
o Droplet: standard surgical mask for provider and patient. Use with: influenza, meningitis,
mumps, streptococcal pharyngitis.
o Contact: standard PPE with strict hand-washing. (MRSA, scabies, varicella-zoster)
• It is better to use more PPE than is necessary.
• Acetaminophen may also be given PR if suppository form available and patient not tolerant of PO
medications.

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