We cover an episode of The Skeptic's Guide to Emergency Medicine that covers a validation study of the Step by Step approach to pediatric fever.  This approach to infants with a fever <3 months old is alluring as it does not necessitate a lumbar puncture.  This algorithm had a better sensitivity and negative predictive value than the Rochester criteria.   The approach did miss some infants with a serious bacterial infection and these tended to be those between 21 and 28 days old and those with fever onset <2 hours prior to arrival.  We cover Chapter 116 in Tintinalli's Emergency Medicine (8th ed) and Rosen's on pediatric fever. Visit FOAMcast.org for more information and thanks for listening! -Jeremy Faust and Lauren Westafer