BACKGROUND Young infants with serious bacterial infections (SBI) or herpes simplex virus (HSV) infections may present to the emergency department (ED) with hypothermia. We sought to evaluate clinician testing and treatment preferences for infants with hypothermia. METHODS We developed, piloted, and distributed a survey of ED clinicians from 32 US pediatric hospitals between December 2022 to March 2023. Survey questions were related to the management of infants (≤60 days of age) with hypothermia in the ED. Questions pertaining to testing and treatment preferences were stratified by age. We characterized clinician comfort with the management of infants with hypothermia. RESULTS Of 1935 surveys distributed, 1231 (63.6%) were completed. The most common definition of hypothermia was a temperature of ≤36.0°C. Most respondents (67.7%) could recall caring for at least 1 infant with hypothermia in the previous 6 months. Clinicians had lower confidence in caring for infants with hypothermia compared with infants with fever (P < .01). The proportion of clinicians who would obtain testing was high in infants 0 to 7 days of age (97.3% blood testing for SBI, 79.7% for any HSV testing), but declined for older infants (79.3% for blood testing for SBI and 9.5% for any HSV testing for infants 22-60 days old). A similar pattern was noted for respiratory viral testing, hospitalization, and antimicrobial administration. CONCLUSIONS Testing and treatment preferences for infants with hypothermia varied by age and frequently reflected observed practices for febrile infants. We identified patterns in management that may benefit from greater research and implementation efforts.

中文翻译：

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急诊室体温过低婴儿的临床医生管理实践。

背景患有严重细菌感染（SBI）或单纯疱疹病毒（HSV）感染的小婴儿可能会因体温过低而被送往急诊科（ED）。我们试图评估临床医生对体温过低婴儿的测试和治疗偏好。方法 我们在 2022 年 12 月至 2023 年 3 月期间对来自 32 家美国儿科医院的急诊科临床医生开展、试点和分发了一项调查。调查问题与急诊室体温过低的婴儿（≤60 天）的管理有关。有关测试和治疗偏好的问题按年龄分层。我们评估了临床医生处理体温过低婴儿的舒适度。结果 在分发的 1935 份调查中，完成了 1231 份（63.6%）。体温过低的最常见定义是体温≤36.0°C。大多数受访者 (67.7%) 记得在过去 6 个月内照顾过至少 1 名体温过低的婴儿。与发烧婴儿相比，临床医生对照顾体温过低的婴儿的信心较低 (P < .01)。在 0 至 7 天大的婴儿中，接受检测的临床医生比例较高（97.3% 进行了 SBI 血液检测，79.7% 进行了任何 HSV 检测），但对于年龄较大的婴儿来说，进行检测的比例有所下降（79.3% 进行了 SBI 血液检测，9.5% 进行了 SBI 血液检测，9.5% 进行了 SBI 血液检测）。适用于 22-60 天婴儿的任何 HSV 检测）。呼吸道病毒检测、住院治疗和抗菌药物管理也存在类似的模式。结论 体温过低婴儿的检测和治疗偏好因年龄而异，并且经常反映观察到的发热婴儿的做法。我们确定了可能受益于加大研究和实施力度的管理模式。