Popular science class
"Home care for children with high fever"
Shanshan's mother
My baby has a fever of 39 degrees. I heard that your baby also had a fever a few days ago. How did you cool her down?
The child was sick, and the whole family was anxious. Grandma told him to cover his head, and his father told him to cool down, and wanted the child to take medicine. Grandpa asked him to take it slow, but the whole family had different opinions. Later, they consulted professionals.
Yiyi’s mother
Shanshan’s mother
What kind of professional guidance have you received? Can you please share it?
Let’s ask the experienced pediatric head nurse of Zhongda Hospital Affiliated to Southeast University to tell parents how to care for children with high fever.
Yiyi mother
Fever-related knowledge
Hyperthermia in children is a common pediatric emergency. Because the regulatory function of the central nervous system of infants and young children is relatively poor, and the sweat glands are not fully developed, their body temperature regulation function is relatively poor, so the risk of hyperthermia is relatively high.
When the child's axillary temperature reaches 39.1℃~40℃, it is high fever, which is clinically manifested as fever, cold sensitivity, loss of appetite, diarrhea, listlessness and other symptoms. Severe cases can lead to symptoms such as dehydration, convulsions, shock, and cerebral edema in children. Many diseases can cause high fever in children, with infectious diseases being the most common. Heat absorption after surgical trauma, allergic reactions, and too much clothing wrapping can also cause high fever in children.
Q1
What is the body temperature for fever?
Usually axillary temperature ≥ 37.5℃ or rectal temperature ≥ 38℃ is defined as fever. Clinically, fever is divided into 4 categories according to body temperature (based on axillary temperature): 37.5~38.0℃ is low fever; 38.1~38.9℃ is moderate fever; 39.0~40.9℃ is high fever; ≥41.0℃ is ultra-high fever.
Q2
Which method of measuring body temperature is more accurate?
electronic thermometer is recommended for families. There are usually 4 places to measure body temperature, namely armpit, under the tongue, eardrum and rectum . The measured body temperature is called axillary temperature, oral temperature, ear temperature and rectal temperature respectively. From the perspective of operability and safety, it is recommended to use underarm measurement .
generally determines the interval for measuring the child's temperature based on the severity of the child's condition, the level and changes of body temperature. Usually, when there is high fever, the temperature should be measured once every 50.5 to 1.0 hours. Too frequent will affect the child's rest; when there is ultra-high fever, the number of temperature measurements should be increased; for moderate fever, the body temperature is relatively stable, and the temperature can be measured once every 52 hours; when there is low fever, the temperature should be measured once every 52 to 4 hours. If your child's temperature or condition changes, you can measure the temperature at any time and keep a record of the temperature.
Q3
The higher the body temperature, the more serious the condition will be?
The severity of the disease cannot be judged simply by the degree of fever. Fever is a pathophysiological response of the body to foreign pathogens or substances. To a certain extent, fever is beneficial to activating the body's immune function. However, when the body temperature of babies less than 3 months old is ≥38℃, and when the body temperature of babies aged 53 to 6 months is ≥39℃, the risk of serious bacterial infection increases, and parents need to pay close attention to it.
Q4
Should my child see a doctor if he has a fever?
If you judge from the child's symptoms that the fever is basically caused by a cold, the general medical treatment principles are as follows:
(1) Infants within three months of age should seek medical attention as soon as they have a fever.
(2) For more than three months, the mother can decide to seek medical treatment based on the child's body temperature and mental condition:
body temperature is higher than 39°C and the mental state is not good;
has a fever for more than three days; severe respiratory symptoms appear, such as shortness of breath, asthma, suffocation, hoarseness, lethargy, and other symptoms that make the mother feel unsure.
How to use antipyretics?
Q1
At what temperature should I take antipyretic drugs?
How to choose antipyretic drugs?
html Babies under 52 months old are prohibited from taking antipyretic and analgesic drugs ;
html children over 52 months old have a body temperature ≥38.2℃ When accompanied by obvious discomfort, drugs can be used to reduce fever;
htmlWhen children over 42 months old have fever and need drugs to reduce fever, acetaminophen is recommended;html children over 56 months old can use acetaminophen or ibuprofen to reduce fever.
Q2
I experience vomiting after taking antipyretic drugs.
Do I still need to take more medicine?
If vomiting occurs immediately after taking it, and complete tablets, capsules or all liquid are seen in the vomitus, consider taking a supplementary dose if necessary.
If the time spent exceeds 15 minutes , the decision will be made on a case-by-case basis, weighing the potential risks of missing a dose against the dangers of overdose after a missed dose.
Q3
Can acetaminophen and ibuprofen
be used interchangeably to reduce fever?
It is not recommended to use acetaminophen and ibuprofen alternately when children have fever.
Although the alternate use of acetaminophen and ibuprofen has some differences in body temperature lowering value compared with the use of acetaminophen or ibuprofen alone, it cannot effectively improve the discomfort caused by fever in children, and at the same time increases the risk of adverse reactions to antipyretic analgesics.
Nursing of children with fever
Q1
What should you pay attention to in your diet when you have fever?
Drink more water to ensure your fluid intake. When children have fever, they consume a lot of calories and lose a lot of water. They should drink more plain water. When they sweat a lot, they should add a little salt to the water to replenish the lost salt. Food should be given that is light, easy to digest, rich in water, and has a certain amount of calories. Such as apples, vegetable soup, rice porridge, milk, etc. You should eat small meals frequently. When you have a fever, but the condition is not very serious, and there is no severe vomiting or diarrhea, you should not avoid excessive food intake.
Q2
Can children with fever use physics to cool down?
What are the physical cooling methods?
Guidelines from various countries do not recommend the following physical cooling measures for antipyretic treatment, including ethanol body rubs, ice water enema and other methods, which will significantly increase the discomfort of children, such as chills, goosebumps, crying, etc.
The methods that can be used for children with fever mainly include warm water external application, warm water baths and antipyretic patches etc. It can also reduce the number of clothes worn, or lower the indoor temperature , etc., so that children with fever can feel comfortable.
Q3
When you have fever and chills, should you continue to physically cool down
or keep warm?
When you have fever and chills, it is not suitable to use physical cooling to reduce fever. During the period of fever and body temperature rising, children will feel chills or aversion to chills, experience shivering, pale skin, etc., and the body's heat production will increase. Physical cooling at this time will significantly increase the child's discomfort, aggravate the symptoms of shivering and chills, and cause a more obvious thermogenic reaction in the body.
When children have fever and chills, we should pay attention to keeping them warm
1. To improve the comfort of children with fever, you can add clothes or cover the children with quilts appropriately. While paying attention to keeping warm, you should not wrap the children too tightly or too thickly. You can add or remove clothing according to their fever status.
2. The ambient temperature of the environment where children live must also be suitable for . Air circulation must be maintained indoors to avoid direct wind and sunlight. The optimal temperature in the ward is 18°C ~ 22°C. It is appropriate to make the child feel warm and comfortable.
3. Children should wear loose clothes and pants with strong ventilation , rest in bed, avoid strenuous exercise, and do not have too many clothes and bedding. If they sweat excessively, they should change clothes and pants in time after bathing with warm water.
Examination and treatment of children with fever
Why do we test blood routine when we have fever?
Is the blood test accurate only after 24 hours of fever?
Among pediatric acute febrile diseases, infection is the main cause.The early clinical manifestations of infection lack pathogen specificity, but the clinical processes and treatment measures of bacterial and viral infections are significantly different. Early identification is conducive to implementing appropriate treatment as early as possible, avoiding the abuse of antibacterial drugs, and reducing the risk of clinical misjudgment. In addition to careful analysis and evaluation of clinical manifestations, routine blood tests are the most commonly used basic auxiliary examination methods to provide clues for identifying the pathogenic nature of infection, inflammatory diseases and other causes.
Research shows that for newborns with acute fever of unknown etiology who are generally in good condition, the sensitivity and specificity of routine blood tests in diagnosing serious bacterial infections are better after 12 hours of fever than before 12 hours.
In addition, if the fever in children with fever fails to subside within 2 to 3 days, , timely blood routine testing should be performed every 48 to 72 hours when the condition changes and the condition changes. This is necessary to judge the condition, analyze possible infectious pathogens, and evaluate the effect of treatment.
Will babies get fever after being vaccinated? How to deal with
fever?
Fever may occur after vaccination. Most of them occur around 5 to 6 hours or 24 hours after vaccination. Some recipients may have fever earlier, appearing 2 to 4 hours after vaccination. If a brief fever occurs after vaccination, the body temperature is below 38.5°C, and there are no other obvious abnormal reactions, most of them are general reactions after vaccination and do not require special treatment. You can drink more water, rest more, and observe closely, and the body temperature will slowly drop.
If continues to have a fever, or a high fever occurs, you need to go to the hospital for a detailed examination and receive corresponding treatment under the guidance of a doctor according to the specific cause.
Tips for home care of children with fever
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I wish every baby
to grow up healthily
Editor's team
planning and review Cheng Shouqin
arrangement Liu Min
proofreading Wang Qian
source Pediatrics
produced by the Integrated Media Center of Zhongda Hospital
