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The primary outcome of adherence to paediatric fever management best practice guidelines was assessed with clinical vignettes and defined as single antipyretic use for the relief of fever\u2010related discomfort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 602 participants (243 doctors, 353 nurses and six unknown; response rate 47.5%), only 64 (10.6%, 95% confidence interval [CI] 8.3\u201313.4%) demonstrated adherence to best practice guidelines. In a febrile settled child with normal fluid intake, the percentage of participants that would use antipyretics doubled with abnormal vital signs (33.7%<jats:italic>vs<\/jats:italic>72.9%, difference\u2009\u221239.2%, 95% CI \u201344.4% to \u221234.0%). Most participants would use antipyretics for reduced fluid intake (<jats:italic>n<\/jats:italic>\u00a0=\u2009494, 82.1%, 95% CI 78.8\u201385.0%) in a febrile settled child. Over half (<jats:italic>n<\/jats:italic>\u00a0=\u2009339, 57.1%, 95% CI 53.0\u201361.1%) would advise giving antipyretics to prevent febrile convulsions. Most (<jats:italic>n<\/jats:italic>\u00a0=\u2009467, 80.0%, 95% CI 76.5\u201383.1%) participants agreed that a RCT of antipyretics in febrile children &lt;2\u2009years of age with relief of discomfort as a primary outcome is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Just over 10% of New Zealand ED doctors and nurses demonstrated adherence to paediatric fever management best practice guidelines. A RCT of antipyretics in febrile children &lt;2\u2009years of age specifically addressing relief of discomfort as a primary outcome is strongly supported.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14022","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T06:05:43Z","timestamp":1653890743000},"page":"943-953","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Paediatric fever management practices and antipyretic use among doctors and nurses in New Zealand emergency departments"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6296-3545","authenticated-orcid":false,"given":"Eunicia","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medical and Health Sciences The University of Auckland Auckland New Zealand"},{"name":"Emergency Department Middlemore Hospital Auckland New 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