Evaluation of the Febrile Patient
The presence of fever in patients in the surgical intensive care unit (SICU) demands prompt attention because infection, often heralded by an elevation in core body temperature, is the leading cause of death in this patient population (1). Fever is defined as “a state of elevated core temperature,” and is present when the oral temperature is higher than 99°F (>37.3°C) in the early morning or higher than 100°F (>37.8°C) at any time during the day. This frame of reference is obviously of limited value when applied to seriously ill patients in the SICU, some of whom may exhibit an absent or blunt response to infection and others who are not candidates for oral temperature measurements. Most authorities consider the thermistor of a pulmonary artery catheter to be the most accurate device for measuring core temperature. However, when pulmonary artery catheters are not in place, most believe that electronic probes, placed in the rectum or external auditory canal, are acceptable alternatives. Measurements from the axilla are unreliable and should not be used (2).
KeywordsSurgical Site Infection Pulmonary Artery Catheter Surgical Intensive Care Unit Toxic Shock Syndrome Febrile Patient
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