FEVERS
Fevers are one of the most frequent triggers of phone calls to a Pediatrician. A fever is defined as a temperature greater than or equal to 100.4 and is a sign of an illness but a fever is not the illness but part of the process which the body uses to fight an illness. It is not to be feared but must be taken as a sign that a child should be evaluated for the severity of his/her disease.The height of a fever is not an indicator of the severity of an illness. A child may have a 104 or 105 fever with only a mild viral illness but could be extremely ill with a mild temperature of 100.5 or even a below normal temperature of 96.5.
• One of the most important parts of the evaluation is to discover the cause of the fever. It is associated with a sore throat, a runny nose and cough, a cough alone, vomiting and diarrhea or vomiting alone, or is the child complaining of abdominal pain or pain with urination.
• The second important part is to evaluate your child for alertness, communication, oral intake of liquids and the ability to look down and put their chin to their chest.
A fever with a runny nose and cough in a child who is alert, interacting, drinking and can look down and has no trouble breathing can be treated symptomatically with Acetaminophen or Ibuprofen for 3 to 4 days.
A fever with diarrhea with less than 12 hours of vomiting in a child who is alert, interacting, drinking and can put their chin to their chest can be treated symptomatically.
Illnesses with fever may be treated symptomatically through the night but should be evaluated by a physician the next day, including fever with a sore throat only, fever with a cough without a runny nose, fever and pain with urination, fever with a cold and mild ear pain, fever in a child older than 6 months with no other signs show is alert, interacting and drinking well.
Illnesses with fever that require immediate consultation with a physician include but are not limited to , fever in a child who is not alert and will not interact with their parent, fever with vomiting only, fever with constant abdominal pain, fever with cough and difficulty breathing, fever in a child who can not look down.
Any infant under 2 months of age with a fever, whether or not they have any other symptoms, needs to be evaluated immediately by a pediatrician.
The above statements are only guidelines. If a parent is every uncomfortable or concerned about a child’s fever and illness, they should contact their Pediatrician.
TREATMENT GUIDELINES
• Make sure your child is taking in plenty of fluids.
• Dress a child appropriately. Heavy insulated clothing will only serve to push a temperature up higher.
• Tepid sponge baths (water temperature 85 to 90 F) are usually not necessary but may be used if temperature is 105, the child is uncomfortable or if the child has a history of febrile convulsions.
Never sponge with alcohol. It has serious side effects including coma.
• Acetaminophen (Tylenol). Do not confuse the concentrated Infant drops with the children’s syrup. (Infant drops are calculated at 80 mg per 0.8 cc versus the children’s syrup which is calculated at 160 mg per teaspoon.) It is dosed at 5 mg per pound every 4 hours. For example: a 16 pound baby would get 0.8cc of drops or ½ teaspoon of syrup, a 32 pound child would get 2 droppers of 0.8cc or 1 teaspoon of syrup every 4 hours.
• Ibuprofen (Motrin). It is difficult to calculate the dosage of Ibuprofen drops so we would rather give the syrup with is dosed at 100 mg per teaspoon. DO NOT GIVE TO CHILDREN UNDER 2 YEARS OF AGE. Ibuprofen is also dispensed at 5 mg per pound every 6 hours. For example: a 22 pound child would receive
1 teaspoon every 6 hours, a 32 pound child would receive 1 ½ teaspoon every 6 hours and a 44 pound child would receive 2 teaspoons every 6 hours.
DO NOT GIVE ASPIRIN TO A CHILD UNLESS DIRECTED BY A PEDIATRICIAN.