Fever

Fever

Fever remains the most common concern prompting parents to present their child to the emergency department. Fever has traditionally been defined as a rectal temperature over 100.4 F or 38 C. Temperatures measured at other body sites are usually lower. The threshold for defining a fever does vary significantly among different individuals since body temperatures can vary by as much as 1 F. Low-grade fevers are usually considered less than 102.2 F (39 C).

Fever (Question & Answer)

Fever
What You Should Know About Fever:
  1. Having a fever means your child has a new infection.
  2. It’s most likely caused by a virus.
  3. You may not know the cause of the fever until other symptoms develop. This may take 24 hours.
  4. Most fevers are good for sick children. They help the body fight infection.
  5. Use the ranges below to help put your child’s level of fever into perspective:
  6. 100° – 102° F (37.8° – 39° C) Low grade fever: helpful, good range. Don’t treat.
  7. 102° – 104° F (39 – 40° C) Average fever: helpful. Treat if causes discomfort.
  8. Over 104° F (40° C) High fever: causes discomfort, but harmless. Always treat.
  9. Over 106° F (41.1° C) Very high fever: important to bring it down. Rare to go this high.
  10. Over 108° F (42.3° C) Dangerous fever: fever itself can be harmful.
Fever
 
Treatment for All Fevers: Extra Fluids and Less Clothing
  1. Offer your child lots of cold fluids to drink. Reason: Good hydration replaces sweat. It also improves heat loss from the skin.
  2. For fevers 100°-102° F (37.8° – 39°C), fever meds are rarely needed. Fevers of this level don’t usually cause discomfort. They do help the body fight the infection.
  3. For all children, dress in 1 layer of light weight clothing, unless shivering. Reason: also helps heat loss from the skin.
  4. Caution: if a baby under 1 year has a fever, never overdress or bundle up. Reason: babies can get over-heated more easily than older children.
Fever
Fever Medicine:
  1. Fevers only need to be treated with medicine if they cause discomfort. Most often, that means fevers above 102° F (39° C). Also use for shivering (shaking chills). Shivering means the fever is going up.
  2. For fevers above 102° F (39° C), give an Pararcetamol product such as. ( Crocin/Calpol/Metacin)
  3. Another choice is an ibuprofen product (such as Ibugesic).
  4. Goal of treatment: Bring the temperature down to a comfortable level. Most often, the fever medicines lower the fever by 2° to 3° F (1 – 1.5° C). They do not bring it down to normal. It takes 1 or 2 hours to see the effect.
Fever

Sponging With Lukewarm Water:

  1. Note: Sponging is an option for high fevers, but not required.
  2. When to Use: Fever above 104° F (40° C) AND doesn’t come down with fever meds. Always give the fever med first.
  3. How to Sponge: Use lukewarm water (85 – 90° F) (29.4 – 32.2° C). Sponge for 20-30 minutes.
  4. If your child shivers or becomes cold, stop sponging. Other option: You can also make the water warmer.
  5. Caution: Do not use rubbing alcohol. Reason: Can cause a coma.
Fever
Return to School:
  1. Your child can return to school after the fever is gone. Your child should feel well enough to join in normal activities.
Fever

What to Expect:

  1. Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C).
  2. They may last for 2 or 3 days.
  3. They are not harmful.
Children hospital
Show Your Doctor If:
  1. Your child looks or acts very sick
  2. Any serious symptoms occur such as trouble breathing
  3. Fever goes above 104° F (40° C)
  4. Any fever occurs if less than 12 weeks old
  5. Fever without other symptoms lasts more than 24 hours (if age less than 2 years)
  6. Fever lasts more than 3 days (72 hours)
Children hospital
Basic dosage of medicines for fever

Key points to remember about paracetamol

Always measure doses exactly. Ask your chemist for an oral syringe – to give your child medicine by mouth.

  1. paracetamol (Crocin /Calpol /T 98 / Metacin) is a medicine to help reduce fever and pain.
  2. your child doesn’t need it for fever alone – if your child is miserable because of the fever, you can give paracetamol to make them more comfortable
  3. too much paracetamol can be dangerous
  4. keep all medicines out of reach of children, in a locked or latched cupboard
  5. before each dose, check if your child still needs it
  6. know the right dose to give and check the strength
  7. give no more than 4 times in 24 hours
  8. if someone else has been caring for your child, ask if they gave your child paracetamol, how much and when
  9. check other medicines your child is taking – they may have paracetamol in them

What is paracetamol?

  1. paracetamol (Crocin /Calpol /T 98 / Metacin) is a medicine to help reduce fever and pain
  2. it will not cause drowsiness or cause your child to sleep
  3. you can use it for children and babies over 3 months old
  4. younger babies must see the doctor

Does my child need paracetamol?

  1. only give paracetamol if it’s necessary
  2. fever is a normal response to infection and is not in itself harmful, so you don’t need to give paracetamol for fever alone
  3. if your child is miserable because of the fever, you can give paracetamol to make them more comfortable
  4. it’s not a good idea to give babies and children paracetamol before and repeatedly after immunisation just in case they feel unwell – there is some evidence that paracetamol may reduce the effectiveness of childhood vaccinations

How long does it take liquid paracetamol to work in children?

It varies between individuals but paracetamol seems to have the maximum effect between 1 ½ and 3 hours after you give the dose. Pain levels and temperature may start to come down before this.

What is the correct dose of paracetamol?

  1. the dose depends on your child’s weight and the strength of paracetamol
  2. always measure doses exactly – ask your pharmacist or nurse for an oral syringe
  3. weigh your child, then check the dosing table below
  4. check the strength – there are 2 strengths
  5. ask the pharmacist, doctor or nurse to show you

For Newborn and Infants the paracetamol is used in the Drops form and not Syrup

Each ml (approx 30 drops) contains:Paracetamol IP : 100mg

Average weight in KgDose in ml
3.8-5.50.6-0.8
5.5-8.30.8-1.2
8.3-101.2-1.5

For children it is used in syrup form available as 120mg/5ml or 240 mg/5ml

Your child’s weight120mg per 5mL250mg per 5mL
5kg or lessAsk doctorAsk doctor
6.5kg4mL2mL
8kg5mL2.5mL
10kg6mL3mL
15kg9mL4.5mL
20kg12mL6mL
30kg18mL9mL
40kg25mL12mL

If your child won’t take liquid paracetamol, and is old enough to safely swallow a tablet, you can give them a paracetamol tablet – make sure to give them the right dose:

Wait at least 4 hours between doses – give no more than 4 times in 24 hours.

  • 1 tablet (500mg) if your child is more than 33kg
  • 2 tablets (500mg each) if your child is more than 66kg

What to do before every paracetamol dose

  1. check your child to see if they need another dose
  2. it at least 4 hours between doses – give no more than 4 times in 24 hours
  3. keep a record of the doses you give your child – check when you gave the last dose, before giving it again