Fever in children under 5 years of age: how safe is home teleconsultation

Abstract

The use of home teleconsultation in outpatient pediatric practice has become widespread in many countries over the world, regardless of their economic situation. Each country has its own experience in the practical implementation of home teleconsultation in medical care for patients, but the issue of increasing its effectiveness remains topical. Purpose - to consider the issue of improving the efficiency and safety of home teleconsultation for children under 5 years old with fever. Materials and methods. The terms «home teleconsultation», «telemedicine sorting», «children», «fever» were searched using Pub Med Central databases. The data of the regulatory and legal protocols in Ukraine were taken into account while determining the recommendations. Results. Research in recent years proves that new forms of communication between a doctor and a patient, his parents or guardians create both additional opportunities and risks regarding various aspects of the quality of medical care. According to the data of literary sources, conclusions were made that the quality of home teleconsultation for children under 5 years of age is affected by: social and ethical features of communication with children and their parents; lack of standards/scenarios for telephone consultation for a specific pathology; lack of appropriate professional training of doctors. The article provides measures to improve home teleconsultation: the use of telesorting scenarios (NICE protocol/standard for children under 5 years with fever) using a «traffic light system», alarm symptoms («red flags») to predict the risk of serious illness and taking into account the availability of the use of the «safety net». There is a well-founded need for professional training of medical workers in the field of telemedical consultation. Conclusions. The implementation of home teleconsultation services in outpatient pediatric practice in situations where a child’s condition is assessed by a medical professional who cannot examine him because the child is geographically distant will contribute to a faster setting of priorities for the provision of primary medical care. In today’s environment, the NICE (2021) protocol/standard for the assessment and initial treatment of fever in children under 5 years of age is a clinical scenario that meets the requirements for home teleconsultation. The introduction of the leading international experience of organizing home teleconsultation for children under 5 years of age is the basis for improving programs of continuous professional experience of medical workers who provide assistance to children. No conflict of interests was declared by the authors.