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Saturday, February 13, 2010

how to treat fever in children? tips and tricks

Child health specialist pediatrician Mumbai says:
Any rise in temperature is a discomfort.. and above 101F it becomes intolerable... and hence requires treatment.

'Highest level of tolerable temp' has no clinical significance as some children show symptoms of hyperpyrexia even at 103 F. and it varies from person to person.

Dr kondekar is available for private consultations at Shushrusha Hospital Dadar(w) Mumbai, monday to friday 7 to 9 pm appointment by sms 9869405747 
 
The question is whether do we need to treat the fever?

fever upto 101F should be watched.. as it may get cured spontaneusly and it can cure the disease at times.
High fever in children, can at times turn lethal; so observing without treatment is no wise.

How do we manage:

1.Switch on Fan /AC, not directed towards pt, air in room should be free flow.

2.take clothes off.. no blankets... a common question always asked is what to do if child is shivering...? The answer is child may shiver.. we may give blanket for 1o min only.. as shivering doesnt last longer and fever starts rising after shiver if a blanket is given. Also shivering is protective while fever may be harmful. SO do take the vlanket off by 10 min... can repeat same.

3. Give an oral antipyretic. In viral infections and malarial fever , the myalgia plays a significant role... so its better to use a combination with ibuprofen or only ibuprofen.. more symptomatic relief. wait for 10 min.

4. Fever coming down : observe. keep opne, turn to side, increase area of heat loss by radiation. ...Fever not coming down: start sponging. continuous or intermittent.

5. Sponging tricks : Keep fan on. dont get scared of shivering. Dont use ice or cold water (why? : its not required ! and it has a risk of ppting hypothermia in children.. children are scared of cold when febrile) use a wet hanky /turkish towel, make it wet.. remove excess water.. spread it over the trunk and tummy... cover maximum surface area, faster relief; till it dries off or becomes hot.. then change the towel, repeat same till temp comes down. Forehead sponging: Most of the times not reqd.. as it carries undue emphasis from movies.. and covers small area. Please dont restrict sponging only to forehead.

TricK: make scalp wet, let the forehead towel cover eyes.. that avoids pricking sensation in eyes.

6. wait another 10 minutes.. temp same or falling... observer and continue. If temperature rising.. try injectable paracetamol... by this we are just increasing the dose of PCM, changing route is only bcos child wont be in a position to take oral; one may try rectal.. equally effective.
There are different fever medicines tylenol, motrin, combiflam,inbugesic, meftal are few trade names, some are combination medicines. some doctors discourage combination medicines. They are available but should not be taken without a prescription by a doctor as some do have side effects in some individuals. 

7. Treat the cause of fever !!

Why prompt relief of fever reqd?

Annoying symptom, discomfort, feb seizure... hyperpyrexic brain damage.

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3 comments:

  1. repeated fever a concern:

    FEVER is commonly caused by infection, so repeated infections is one possibility in repeated fevers. upto 6-8 infections per years is common upto 3 year age. if the fever doesnt last for more than 1 day each time, it need not be a problem, cause such fevers are often due to heat, activity etc some children may eb more prone for repeated infections as they may have low weight, low immunity or some background disease.

    one cant zero down each time on the cause of fever just by description, as many times body warmth is perceived as fever. i will recommend you to measure fever each time. usually temperatures below 99 are not considered seriously as fever. some rare causes of persistant fever are like say thyroid related issues, low hemoglobin, some connective tissue diseases and some malignancies. but if u dont have a proper documentation of fever each time, jumping to any conclusion is useless.

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  2. Post or paste your query here: My Son is having continous fever & it reaches to a peak of 102-104 degrees.
    The fever doesnot responds to Crocin DS, but comes down when Ibugesic plus is given.

    Blood culture report is awaited, Urine n Blood test including widal & malaria test are negative.

    Please suggest what to give to lower down the fever.
    1. Croocin DS / Metacin Sursa
    2. Inugesic plus
    3. Ibugesic
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    answer: i think following link may give some answers to yoru query http://childrenspecialist.blogspot.com/2010/02/how-to-treat-fever-in-children-tips-and.html. also dose of the medicine depends on the weight. for example paracetamol (crocin) dose is around 150 mg for 10 kg child. low dose is likely to cause less effect.

    also some fever meds act rapidly but act for short (PARACETAMOL), some ACT FOR LONG BUT MAY ACT SLOW (ibugesic).

    a combination of the two may be preferred by soem doctors.

    ibuprofen may be not recommended in allergy, cough and gastritis. it may also cause low platelets. but a doctors decision will override these risks

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  3. hi there
    fever medicines can have seriosu side effects at times. doctors do take them into consideration while prescribing same.

    paracetamol in 20 times heavy dose causes lover toxicity. Most pediatricians may restrict its use in liver disease, though it may be needed.
    ibuprofen containing medicines are blamed for gastric acidity, stomach bleed and low platelets; so much so that good number of pediatricians are scared of using it in below 6 months, in malaria and even dengue fever.
    mefenamic acid may be related to hyperalertness and overdose may cause convulsions; many pediatricians restrict its use saying it is less effective too.
    combination fever medicines may help in some cases but often science evidence talks against them.

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