Reduction in fever with antipyretics is not significant in terms of risk stratifying.
Remove the fever as a confounding factor. I.E.
Give antipyretics to make sure the child improves clinically when not hot and that tachycardia, tachypnoea etc. resolve with the fever.
Can be difficult to accurately quantify.
It is in general not normal for a child to cross their centile.
Abnormalities in the FBC should prompt a blood film.
Abnormal blood film should prompt a bone marrow aspirate.
Can present with fever, fatigue, bruising, bleeding, lymphadenopathy, limp.
Additional tests for the ED include G+S, LDH and markers for possible tumour lysis – K+, creatinine and uric acid. Ca2+, PO4+, TP, Albumin are also useful.