Clinical decision support that reasons like a pediatrician: work up the febrile young infant by the AAP bands, manage bronchiolitis with supportive care, reassure the simple febrile seizure, and set the phototherapy threshold — with the decision rule and exactly what would change it. Built for verified physicians.
Two real pediatrics questions, each reasoned the way HeyHippocrates answers: the skills fire, the answer is cited, the decision rule is explicit, and what's missing is flagged. Scroll to each.
A well-appearing 25-day-old with a rectal temperature of 38.5°C — the workup?
At 22 to 28 days the AAP still treats fever as high-risk. Obtain a urinalysis and urine culture, a blood culture, and inflammatory markers — procalcitonin, CRP and the absolute neutrophil count — and perform a lumbar puncture. Start empirical antibiotics and admit. Under 22 days, the full evaluation with an LP and empirical antibiotics is mandatory regardless of how well the infant looks; the young infant hides serious infection.
Decision ruleFebrile infant 22–28 days → urine + blood culture + inflammatory markers + LP, empirical antibiotics, admit; under 22 days → full workup + LP + antibiotics regardless of appearance.
Not established from this alone — the exact age band, the inflammatory markers and the appearance change the extent of the workup.
A 6-month-old with wheeze, cough and coryza in RSV season, oxygen saturation 93% — the management?
Bronchiolitis is a clinical diagnosis managed with supportive care: nasal suctioning, hydration and supplemental oxygen for hypoxemia. The AAP recommends against routine bronchodilators, corticosteroids, antibiotics and chest radiography — none change the course. Assess feeding and work of breathing, and admit for hypoxia, apnea, poor feeding or respiratory distress. Most infants improve with time and support alone.
Decision ruleBronchiolitis → supportive (suction, hydration, oxygen for hypoxemia); AAP advises against routine bronchodilators / steroids / antibiotics / chest x-ray; admit for hypoxia / apnea / poor feeding / distress.
Not established from this alone — the age, the work of breathing and the feeding change the need for admission.
Illustrative simulations. The physician always decides.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
The AAP 2021 guideline stratifies the well-appearing febrile infant of 8 to 60 days by age band and inflammatory markers. From 8 to 21 days, do the full evaluation — urine, blood and cerebrospinal fluid cultures with empirical antibiotics and admission. From 22 to 28 days and 29 to 60 days, urine and blood cultures with procalcitonin, CRP and the ANC guide whether a lumbar puncture and antibiotics are needed. Any ill appearance mandates the full workup.AAP 2021
Decision ruleAAP: 8–21 d full workup + LP + antibiotics + admit; 22–28 d and 29–60 d use urine/blood culture + inflammatory markers (procalcitonin/CRP/ANC) to guide LP and antibiotics; ill-appearing → full workup.
Missing data: the exact age, the markers and the clinical appearance change the extent.
Supportive care is the treatment: nasal suctioning, maintaining hydration and supplemental oxygen when the saturation is persistently low. The AAP recommends against routinely using bronchodilators, systemic corticosteroids, antibiotics or chest radiography, because none alter the natural course. Reserve testing and admission for the infant with hypoxia, apnea, dehydration or increasing respiratory distress.AAP · bronchiolitis
Decision ruleSupportive only — suction, hydration, oxygen for hypoxemia; against routine bronchodilators / steroids / antibiotics / chest x-ray; admit for hypoxia / apnea / dehydration / distress.
Missing data: the age, the oxygenation and the feeding change the disposition.
A simple febrile seizure — generalized, under 15 minutes, once in 24 hours, in a child of 6 months to 5 years — needs no routine blood work, EEG or neuroimaging. Direct the evaluation at the source of the fever, and consider a lumbar puncture only when meningeal signs are present or the child is under 12 months and under-immunized. Reassure the family: simple febrile seizures do not cause brain damage and rarely become epilepsy. A complex or focal seizure needs more.AAP · febrile seizure
Decision ruleSimple febrile seizure (generalized, under 15 min, once per 24 h, 6 mo–5 yr) → no routine labs / EEG / imaging; evaluate the fever source; LP only for meningeal signs or young and under-immunized; complex or focal → investigate.
Missing data: the seizure features, the age and the immunization status change the workup.
Plot the total serum bilirubin against the hour-specific AAP 2022 nomogram, adjusting the threshold for gestational age and neurotoxicity risk factors such as isoimmune hemolysis, sepsis or low albumin. Start phototherapy when the level crosses the age-based threshold, hydrate and support feeding, and escalate toward exchange transfusion as the level approaches that line. Always check a direct antiglobulin test and the trajectory, not a single value.AAP 2022
Decision rulePlot TSB on the hour-specific AAP 2022 nomogram by gestational age + risk factors; phototherapy at threshold; support feeding; escalate to exchange transfusion near that line; track the trend and the DAT.
Missing data: the hour of life, the gestational age and the risk factors change the threshold.
Your whole practice, one specialist brain — grounded in champion-authored, cited knowledge.
A generalist pediatrics colleague across fever and serious infection, respiratory illness, neonatal care, fluids and GI, seizures and development — cited, non-directive, always with the decision rule.
Deep specialist agents for neonatology, pediatric infectious disease, pediatric pulmonology and pediatric emergency medicine — each its own soul and knowledge base — plus your own uploaded materials.
From the febrile-infant LP to the phototherapy line the margin is thin. Only one of these reasons like a pediatrics colleague whose every claim you can trace.
The waitlist is a founding cohort. Members shape the pediatrics build, get in before anyone else, and lock the founding price for good.
Leave your name and work email. We'll reach out the moment pediatrics opens — with your Founding Pediatrician offer.
One email at launch. No spam, ever.
It reasons in the frameworks you use — the AAP febrile-infant bands, the bronchiolitis guideline, the febrile-seizure criteria and the bilirubin nomogram — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Residents use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion in clinic and on the ward. Access is gated to verified physicians.
Neonatology, pediatric infectious disease, pediatric pulmonology and pediatric emergency medicine each have their own deep specialist agent on the Pro plan, on top of the full pediatrics scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in champion-authored, cited pediatrics knowledge — traceable, not hallucinated — and always states the decision rule plus what data is missing, instead of a confident guess.
HeyHippocrates