Aches, Pain, Fever
There are few things that bring a child to the doctor faster than a fever. Fever is one of the most misunderstood symptoms in all of medicine. There are several common myths about fever. Fever less than 106 degrees F (41.0 degrees C) does not "cook the brain". Fever serves as one of the body's natural defenses against bacteria and viruses which cannot live at a higher temperature. Also, the body's defense mechanisms seem to work more efficiently at a higher temperature. Fever is just one part of an illness, many times no more important than the presence of other symptoms such as cough, sore throat, etc.
How should I take a temperature?
Measuring An Axillary (under the armpit) Temperature:
Axillary temperatures are not as accurate as rectal or oral measurements. Studies show that glass thermometers must be left in place for approximately ten minutes to accurately measure an axillary temperature. An axillary temperature will read approximately one degree lower than a simultaneously obtained oral temperature.
Measuring Fever By Eardrum Temperature:
Eardrum temperature measurements are not accurate in small children. and should not be used in children under 3 years (36 months) of age. This is especially true in infants below 3 months of age when obtaining an accurate temperature is very important.
Measuring Fever By Oral Temperature:
Older children and adults can have their temperature taken under the tongue with their mouth closed. A standard glass and mercury thermometer should be left in place for at least 3 minutes. Make sure to shake down the thermometer before using it. The tip of the thermometer should be placed as far back under the tongue as possible. Oral temperatures will be inaccurate if you have had hot or cold drinks within 20 minutes of temperature measurement.
Measuring Fever By Rectal Temperature:
Infants should have rectal temperature measurements. A standard glass and mercury thermometer should be left in place for a minimum of 3 minutes. Make sure to shake down the thermometer before using it. Appropriate care should be taken in inserting, maintaining and withdrawing the rectal thermometer. To take a rectal temperature safely, place the child prone (stomach side down) on a firm surface. After separating the buttocks, insert a lubricated thermometer approximately 1 inch into the rectum. After at least 3 minutes, remove the thermometer. A rectal temperature will read approximately one degree higher than a simultaneously obtained oral temperature.
Measuring Fever By Electronic Thermometer:
Electronic thermometers that are designed to be used orally (in the mouth) or rectally are an acceptable alternative to a glass thermometer and take a temperature more quickly. They are, however, more expensive than the glass alternative. Strips that measure temperature on the forehead are not accurate and should not be used.
How is fever treated?
Generally, if the fever is not causing a person to be uncomfortable, the fever itself need not be treated. It is not necessary to awaken an adult or child to treat a fever unless instructed to do so by your health care practitioner. If you wish to treat a fever, acetaminophen (Tylenol and others) can be used to lower a fever. The recommended pediatric dose can be suggested by the child's health care worker . Adults without liver disease or other health problems can take 1000 mg (two "extra strength" tablets) every 4-6 hours. Ibuprofen (Motrin/Advil) can also be used for fever in patients over 6 months of age. Again, discuss the best dose with your doctor. For adults, 400-600 mg (2-3 200 mg tablets) can be used every 6 hours. Aspirin should not be used for fever in children or adolescents. Aspirin use in children and adolescents during a viral illness (especially chicken pox and influenza ) has been associated with "Reye Syndrome." Reye Syndrome is a dangerous illness which causes prolonged vomiting, confusion, and even coma and liver failure.
An individual with a fever should be kept comfortable and not overdressed. Overdressing can cause the temperature to go higher. Tepid water (85 degrees F <30.0 degreesC>) baths may help bring down a fever. Never sponge a child or an adult with alcohol; the alcohol fumes may be inhaled causing many problems.
When should I seek medical care for a fever?
Any child below the age of 3 months who has a temperature of 100.4 degrees F (38 degrees C) should be seen by a physician or other healthcare worker. If a child or adult has a history of cancer , AIDS, or other serious illness, such as heart disease or diabetes, medical care should be sought.
Otherwise examine the person with the fever. If they appear sick or have symptoms that would suggest a major illness, such as meningitis (headache, stiff neck, confusion, problems staying awake), urinary tract infection (shaking chills, burning with urination), pneumonia (shortness of breath, cough), or any other signs of a serious illness, you should contact your healthcare worker.
On the other hand, if the fever is accompanying something as simple as a cold, you can treat the fever as above and be assured that the fever is only a symptom of the illness. This is not to say that you should ignore a fever. If there are other associated symptoms that are bothersome, you should contact your health care professional to discuss your particular concerns.
About 3% of all children between 18 months to 3 years of age will have a seizure (also known as a convulsion) with high fever. Of this group of individuals with history of febrile convulsions, approximately one third will have another seizure associated with another febrile episode. Febrile seizures, while frightening to the parents, are not associated with long-term nervous system side effects. Children may be put on phenobarbital following a febrile seizure for prophylaxis. - Although a fever could be considered any body temperature above the normal 98.6 degrees F (37.0 degrees C), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38.0 degrees C).
- Most fever is beneficial, causes no problems, and helps the body fight off infections. The main reason for treating a fever is to increase comfort.
- Children under 3 months old with a temperature of 100.4 degrees F. (38.0 degrees C.) or greater should be seen by a healthcare worker. They may be quite ill and not show any signs or symptoms besides a fever. Infants less than 6 weeks old should be seen Immediately by their doctor.
- Acetaminophen (Tylenol and others) and ibuprofen (Advil, Motrin) can be used to treat a fever. Aspirin should not be used in children or adolescents to control fever.
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