Pediatric Community

  • 1.  Infants Low Temp and ESI Danger VS

    Posted 21 days ago

    Hello,

    Recently we had a newborn, less than 10 days old into our ED and the temperature at triage was 36.4*C rectally.

    This raised red flags for me that they were not brought back and an ESI 2 because of the association between low temperatures in young infants and sepsis.


    Looking at the ESI criteria, they only call out elevated temperatures in pediatrics, not drops in temperature.

    Does anyone have guidelines or policy in place on how low is too low for a rectal temperature on an infant who is ill - not talking a hypothermic situation with a cold water drowning or exposure event.

    Thank you!



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    Elizabeth Leming BSN;BA;CCRN
    Clinical Practice Specialist
    Children's Minnesota
    St Paul MN
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  • 2.  RE: Infants Low Temp and ESI Danger VS

    Posted 21 days ago

    This is a great catch, and I never realized the low temps were not on the ESI. 

    For my facility, we say these are "danger vital signs"



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    Amanda Yarber, RN
    Pediatric Trauma PI and Emergency Care Coordinator
    Niswonger Children's Hospital
    Ballad Health
    Johnson City, TN
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  • 3.  RE: Infants Low Temp and ESI Danger VS

    Posted 20 days ago
    Good Morning, Elizabeth,

    Here is the link to one of the resources available in the EIIC Toolkit for Pediatric Readiness in EDs. It is the CHOP pathway for sepsis in children. It includes hypothermia as criteria suggestive of sepsis. https://www.chop.edu/clinical-pathway/sepsis-emergency-department-inpatient-picu-clinical-pathway
    It can be found with other protocols and pathways at https://emscimprovement.center/domains/pediatric-readiness-project/readiness-toolkit-checklist/ under the "Improve" tab. 
    In addition, this is a link to a clinical pathway from OHSU for neonates with hypothermia https://www.ohsu.edu/sites/default/files/2025-06/DCH%20Clinical%20Pathway%20Young%20Infant%20Hypothermia_June_2025.pdf

    Hope these will help.