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I did misread the age of the child. However, the overreaction of the doctor in calling CPS is still unwarranted considering the temp was dropping after fluids. This child should have been admitted, NOT have CPS called. When the child’s temp dropped to normal for a 24 hour period, no spinal would be needed.

With that, if you think the risk of a spinal tap on an infant is the same as that of an IV, I’m REALLY glad you are not treating my children.
http://www.sciencedaily.com/releases/2009/03/090318113559.htm

It may be a whole lot easier to find spinal fluid than to find a vein, but it IS riskier.

You’re not talking to a lay person here.

Your article is about tiny amounts of bleeding causing difficulty with diagnosing intracranial bleeding and is irrelevant in febrile infants. Bleeding is a very low risk in LP. Of course, any time a needle punctures the skin there is a risk of infection, and infection in the spinal canal would be bad, but so would an infection introduced into the bloodstream through a vein, which is much more likely to occur when a procedure is difficult. I stand by my comments on LPs in infants.

The 'standard of care' for febrile infants includes LP. Not doing it would be like not doing an EKG in a 65 y/o who comes in with chest pain because they 'look ok'. The fact that LP is more invasive is irrelevant, it is still just as necessary. Here's an article from JAAPA (Physicians' Assistants, not evil doctors) that details the need for a septic workup which includes LP in all febrile infants with fever (100.4 by their definition).
http://www.jaapa.com/managing-the-febrile-infant-what-is-the-standard-of-care/article/124184/

What happens to the fever is irrelevant, once it is there it would be negligent not to do the proper workup, and no 'second opinion' will change that. I would have made reasonable accomodations for the mom to talk with the husband or her pediatrician about that need, but only for the mother's benefit...the child needs the LP and/or hospitalization, and at some point the delay in that decision is putting the child at risk.

As far as calling CPS, I don't know. I don't need them to do what I need to do in the ER, security takes care of that, but I have good pediatrician and nursing admin. support, so they'd have made those decisions based on the need to keep the child in the hospital. I don't know what was available in this ER, and at some point the emergency custody needs to be formalized.

This 'doofus' doc was educated in an American med school, residency trained at Johns Hopkins, and is board certified in Emergency Medicine...and he was doing exactly the right thing. Maybe he was impatient with the mother, maybe he was insensitive. Maybe he had an ER full of injuries, pneumonias and heart attacks. Maybe mom was a space cadet....don't know any of that. What it comes down to is the baby needed the workup he wanted to do, and he did what he had to do to get it done.