In special periods, if the baby unfortunately becomes "yang", you must not seek medical treatment in a hurry, especially the common misunderstandings of using antipyretic drugs. In fact, we must first understand that fever is not the primary disease, and it is often a physiologic

Author: Hubei Provincial Third People's Hospital Zhu Xiaoyan and Fang Shasha

During the special period, if the baby unfortunately becomes "yang", you must not seek medical treatment in a hurry, especially the common misunderstandings of using antipyretic drugs should be kept in mind!

Misconception 1: Excessive care about whether the body temperature returns to normal

Currently, research shows that it is not recommended to restore normal body temperature as the main goal of antipyretic treatment. For healthy children with acute fever, treatment should focus on to improve comfort rather than reduce the temperature .

In fact, we must first understand that fever is not the primary disease, and it is usually a physiological process that effectively fights infection. When the human body develops fever, the number and activity of various immune cells will increase, and the immune system will be greatly enhanced. In layman's terms, when the baby is suffering from fever, his immune system is equivalent to silently upgrading.

Misunderstanding 2: ibuprofen and acetaminophen alternately mixed with

my country's "Expert Consensus on Rational Drug Use of Antipyretic Analgesics in Symptomatic Treatment of Children's Fever" Guide clearly states that does not recommend acetaminophen combined with ibuprofen for children to reduce fever, nor does acetaminophen and ibuprofen alternately for children to reduce fever. Although studies have shown that acetaminophen combined with ibuprofen or alternately used with ibuprofen, it is better to reduce body temperature than to use either drug alone, but it cannot improve comfort, and will increase the risk of adverse drug reactions.

Misunderstanding 3: Use antipyretic analgesics and Chinese patent medicines for colds

Home Guidelines in my country clearly state that does not recommend the use of antipyretic analgesics and compound cold medicines containing antipyretic analgesics. single-ingredient antipyretic analgesics and combined with compound cold medicines containing the same drug ingredients are at risk of repeated use or even overdose poisoning. Therefore, these two types of drugs should be avoided in combination.

Common compound cold medicines containing acetaminophen is as follows:

Aminophen Mame Syrup

aminophena magma oral solution	ammonia cabbage sensitivity solution
Children's Compound Aminophen Renin Tablets
Children's Aminophen Alkane Mineral Granules
Pediatric Aminophen Alkane Mineral Granules	Ammonia Huangmin Oral Solution
aminophen pseudo-manamin chewable tablets	aminophen pseudo-manamin dispersion tablets (III)
aminophen pseudo-manamin dispersion tablets (III)
aminophen pseudo-alkaneamine tablets for children
Pediatric Ammonia Huangmin Granules	Pediatric Aminophen Huangnamin Tablets

Misunderstanding 4: Excessive dependence on physical cooling

Research shows that although the effect of de-heating in acetaminophen combined with physical cooling in a short period of time is better, some physical means may significantly increase the discomfort of children. Ice water or ethanol wiping bath are not recommended to reduce the heat.

Excessive or large-scale use of physical methods to cool the body will instead cause the body to overcome the effect of physical cooling by strengthening heat production (cold war) and further reducing heat dissipation (skin capillaries contract, skin goose bumps caused by contraction of the erectile muscle).

In addition to avoiding these misunderstandings, parents and friends master the following small skills, which may solve urgent needs at critical moments.

. Learn to identify the baby's mental state

Comfort assessment can be carried out from multiple dimensions of the child's mental, mood, eating, activity and sleep.Based on current evidence-based evidence and clinical practice, the Chinese version of the "Newborn Pain and Discomfort Scale" and the Wong-Baker Facial Expression Pain Scale are mainly recommended to evaluate the fever comfort of children aged 0 to 5 years old.

2. Learning to judge risk factors

initial evaluation of children with fever is very important. The color of the skin and mucous membranes and the respiratory rate can be used to initially evaluate whether the child needs to go to the hospital.

reversal to the outside world Should be normal, happy or smiling, awake or awaken quickly, crying normally and powerful/no crying

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nose wings incitement, shortness of breath: 6~12 months old, breathing frequency >50 Times/min;＞12 months of age, breathing rate>40 times/min; oxygen saturation ≤95% (inhalation air), the lungs smell wet slurring

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Skin and eyes are normal, mucosa is moist

~6 months old, body temperature ≥39.0℃, fever ≥5d, chills, limbs or joints swelling, limbs cannot bear weight/will not to move

Symptoms and signs	Green area-low risk	Yellow area-middle risk	Yellow area-middle risk html l4	Red Zone-High-risk
Skin mucosa color activity	sdon't be the color of skin, lips and tongue normal
pale (parent description) abnormal reaction to the outside world, no smile, can awaken after long-term stimulation, activity decreases	pale, pattern, gray or cyanotic has no response to the outside world, has a pathological face, can't wake up, sleepy, weak, cries sharply or continues to cry quarrel
breath	dry	-	-
0
Tachycardia: <12>Hing heart rate >160 times/min; 12~24 months of age, heart rate>150 times/min; 2~5 years of age, heart rate>140 times/min; capillary refilling time ≥3s, mucosa is dry, feeding is difficult, urine volume decreases	Skin Poor elasticity
Other	No symptoms or signs of "yellow area" or "red area"
<3> rash pressure does not fade, the anterior fontanelle, neck stiffness , convulsion persistent state, there are signs of nervous system localization, focal convulsion

Fever children in the "green zone" can be cared for at home, but they need to know when further medical treatment is needed.

If the fever child has clinical manifestations of "yellow area", he should seek medical treatment as soon as possible;

If the fever child has clinical characteristics of "red area", he should seek medical treatment immediately.

3. Learning to correct physical cooling

Appropriate care for children with fever can improve the comfort of children. During the fever process, there are three stages: the rising temperature period, the continuous high temperature period, and the decline period of the body temperature. Appropriate physical anti-heat methods are adopted according to different stages, such as applying warm water to children's forehead, reducing clothes they wear, fans and reducing indoor temperatures, etc. These can take away the heat from the body through conduction, convection and evaporation, making the children with fever feel comfortable.

Pharmacist summary

. Parents and nursing staff should learn more about the benefits of fever, as well as how to identify and deal with dangerous signs, and judge the overall condition rather than just focusing on fever.

2. For healthy children with acute fever, the purpose of treatment should focus on reducing discomfort rather than reducing body temperature.

3. Before considering the use of antipyretic drugs, the surrounding environment should be improved.

4. Antipyretic drugs should not be used in combination, nor should they be used interchangeably, only when the child has obvious discomfort.

5. Antipyretic drugs should not be given for the purpose of preventing fever convulsions. External cooling may increase discomfort and metabolic tension.

Reviewer: Hubei Provincial Third People's Hospital Deputy Director Pharmacist Anwei

or above is the original work of volunteers of the "Drug Safety Cooperation Alliance". If reprinted, please indicate the author and source!

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