"Fever and pain are common occurrences throughout a child's life many incidences of which can be safely managed by parents without the need to consult a healthcare professional. Yet many parents feel unsure about the most appropriate way to manage fever or pain, when to treat, what to treat with, and specifically when to seek advice from a healthcare professional."
Dr Lyn Ventilacion and Dr Terry Maguire
FEVER
Definition of fever: Fever is when a human's body temperature goes above the normal range of 36 - 37 ०C.
Fever has a beneficial effect in helping children fight off infection, and regardless of the severity, the majority of fever cases are benign. Fever is one way of immune system attempts to combat an infection.
WHO guidelines for fever management are to treat the distress of the child not only the fever.
FEVER: SYMPTOMS
Feeling cold when nobody else does and sweating
Shivering
Dehydration - preventable if the person drinks plenty of fluids
Depression
Increased sensitivity to pain
Lethargy
Problems concentrating
Sleepiness
FEVER: CAUSES
An infection
Some medication
Rheumatoid arthritis
Dehydration
Overexposure to sunlight or sunburn
Heatstroke
FEVER TYPES:
Low grade; from 38.1 - 39 C
Moderate: from 39.1 - 40 C
High: from 40.1 - 41.1 C
Hyperpyrexia: above 41.1 C
WAYS TO TAKE A TEMPERATURE:
There are different thermometers on the market. Read the instructions for use of the thermometer which you are about to use before taking a temperature. Ensure that you choose the setting as per age group if there are different settings on the device you are about to use.
RECTUM : ( Birth to 3 years)
Most accurate method
Ensure that the tip of the thermometer is clean
Lubricate the tip of the thermometer
Gently insert the tip into the rectum
Wait for the beep
EAR: ( 6 months + )
Quick, safe and accurate method
Ensure ear canal is free of wax
Gently insert ear thermometer firmly
Click for a reading
FOREHEAD: ( any age)
No fuss method
Follow the instructions of the thermometer which you use
Aim to the forehead and hold it the correct distance from the forehead
ARMPIT : (any age)
Least reliable method but easy to use
Place the digital thermometer under the baby's armpit
Hold baby's arm firmly in place
Wait for the beep
WAYS TO REDUCE FEVER:
Give antipyretics or analgesics (speak to your pharmacist about the medication)
Give a lukewarm bath or sponge off with lukewarm water
Offer frozen treats and extra fluids
Don't overdress them in warm clothes even when the child feels cold
You may use a fan or air conditioner but not directly on the child
Hug them, a mother's touch has a similar effect as medication
Do not give aspirin
FEVER: When should I consult a doctor?
Less than 3 months old:
Any fever or you suspect a fever
Less than 2 years old:
Fever lasting for more than 24 hours
Seems sick
More than 2 years old:
Fever lasting for more than 72 hours,
(conservative it is advisable to contact your doctor earlier if fever is
persistent for 24 to 48 hours, 72 hours is according to the following article
https://www.mountelizabeth.com.sg/healthplus/article/fever-in-babies#content)
Shows no other signs or symptoms
Seems sick
All ages:
Signs of dehydration
Fever or dry nappies
No tears when crying
Sunken eyes
Has an unexplained rash
Persistent vomiting or diarrhoea
Change in behaviour
Headache with neck pain
Persistent fever
WHEN TO SEEK IMMEDIATE MEDICAL ATTENTION
Appears ill, drowsy or unresponsive
Difficulty in breathing
Has a rash that doesn't fade easily
Has stiff neck, severe headache or seizure
Inconsolable crying
Persistent vomiting with the presence of bile or blood
The soft spot on the top of their head (fontanelle) curves outwards
The weak, high pitched cry that's not like their normal cry
REFERENCES:
National Institute for health and care excellence, clinical guidelines [CG 160]
Chiappini E, et.al guidelines for the symptomatic management of fever in children, a systematic review of the literature and quality appraisal with AGREE11BMJ Open 2017;7 e015404