Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYN Medical Emergencies: Fever -7041

FEVERPatients Presenting with Fever as the Main Complaint

HISTORY Age Duration of fever Severity of fever Past medical history Medications and Allergies Immunocompromised (transplant,

HIV, diabetes, cancer) Environmental exposure Last acetaminophen or Ibuprofen

SIGNS AND SYMPTOMS Warm Flushed Diaphoretic Chills or rigors Malaise, cough, chest pain,

headache, dysuria, abdominal pain, mental status changes, rash

ASSESSMENT Infections/ Sepsis Cancer/ Tumors/ Lymphomas Medications or Drug reaction Connective tissue disease

(Arthritis, Vasculitis, Lupus) Hyperthyroid Heat Stroke Meningitis

TREATMENT GUIDELINESR-EMR E-EMT A-EMTA P-PARAMEDIC **M-Medical Control

*****Higher level of providers are responsible for lower level treatments***

Initial Patient Contact (2000). Oxygen Administration (9000). Infection Control (1031). R Orthostatic blood pressure measurement. Temperature Measurement (9047). Pulse Oximetry (9001). Assist ALS with Cardiac Monitor and 12-lead EKG (9030) if indicated. Transport to receiving facility as indicated with ALS intercept if patient is

severely ill.

E

Establish IV with NS, draw labs; do not delay transport for IV access.2

If orthostatic, administer bolus of NS, 10-20 cc/kg IV.2 A ALS required for Fever >102 degrees if associated with ALOC, Stroke,

Respiratory Distress, Hypotension or Shock. For temperature >100.4 °F, consider administration of Ibuprofen 10 mg/kg PO,

max 800 mg (age >6 months), or Acetaminophen 15 mg/kg PO/PR, max 1000 mg (age >3 mos).

Go to appropriate Guidelines for other specific complaints.

P ** Call Medical Control for Fever in the presence of any unusual presentation. M2EMT providers may perform these procedures if credentialed with the appropriate OM.Pearls:Patients with a history of liver disease or failure should not receive acetaminophen.Rehydration with fluids increases the patient’s ability to sweat and improve heat loss. All patients should have drug allergies documented prior to administration of pain medications. NSAID’s should not be used in the setting of environmental heat emergencies. Do not give aspirin to a child.Droplet Precautions: include standard Infection Control Guidelines plus a surgical mask for providers who accompany patients in the back of the ambulance and a surgical mask or NRB O2 mask for the patient. This level of precaution should be used when influenza, meningitis, mumps, streptococcal pharyngitis, and other illnesses spread via large particle droplets are suspected. Patients with potentially infectious rash should also be treated with Droplet Precautions.

_______________________________________________________________________________________________________________________________________BCEMS Medical DirectorEffective: 04/01/14 final 5/8/2023 page 1 of 2

Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYN Medical Emergencies: Fever -7041

Airborne Precautions: Include standard Infection Control Guidelines plus a gown, change of gloves after each patient contact and strict handwashing precautions. This level of precaution is used when multi-drug resistant organisms such as MRSA, scabies, Zoster (shingles), or other illnesses spread by contact are suspected.

_______________________________________________________________________________________________________________________________________BCEMS Medical DirectorEffective: 04/01/14 final 5/8/2023 page 2 of 2