• Rubin D

• Association of Chiropractic Colleges / congresses

Objective: To present a case study of a seriously ill child and identify how Observation Scales helped guide our decision-making process.

Clinical features: This is a case study of an acutely ill two-month-old male in a private chiropractic practice. The infant presented to this office in an acute febrile crisis that had come on suddenly within the course of the day and seemed to the parent to be rapidly progressing. The child also had diarrhea that had started shortly before the office visit. The two main questions one has to ask whenever there is fever of unknown origin in an infant are whether the child is seriously ill and is the cause meningitis?

Assessment: Through the examination of six items on an observation scale, it was possible to determine whether there was a need for immediate referral versus adopting a ‘wait-and-see’ attitude by giving the child an observation scale grade. Through use of the observational scale it was determined that although this was a moderately ill child, it was neither a serious illness nor meningitis.

Discussion: Chiropractors need to be able to recognize emergency situations involving young children with fevers that require medical co-management. The observational scale can help chiropractors be prepared to make a clinically important assessment as to whether a patient is seriously ill and requires co management. The practitioner and the student will find that this measurement tool can build our confidence and effectiveness as primary care clinicians. The observation scale can be of tremendous benefit in the family chiropractor’s day-to-day decision making processes.

This abstract is reproduced with the permission of the publisher.