Asked by
rajesh goyl
in
Personal Health
at
7:52 AM on April 26, 2008
Rekha's Answer
Having outlined the essentials of fever management in the previous post, let me go ahead and tell you exactly what needs to be done when your precious child has fever. For the purpose of this discussion, I will exclude babies less than one year of age in whom fever can be an emergency and medical attention by a doctor or a trained nurse or medical assistant is of paramount importance.
First of all, you should know that the normal body temperature varies between 97 and 99 degrees Fahrenheit depending upon the age of the person and the climate and environment in which the person resides. The mean normal body temperature is 98.6 F. A temperature rise of more than 1 degree F from this mean is defined as fever.
Considering this basic point, please remember that a slight body warmth in the middle of the day, or after you have brought the child in from the outside heat, or after the child returns from active play is NOT fever. Neither is the body said to be "febrile" if the child has an ear temperature (taken with the ear-thermometer) of about 99.8 F or less. The internal body temperature is about 1 F higher than the temperature of the arm-pit (axilla), which, in turn, is 1 F higher than the temperature of the skin over the toes or lower legs.
A rise in body temperature in an otherwise well-looking child may or may not mean that worse problems are on their way, and hence, careful monitoring is necessary in every child with fever. Fever is generally due to infections, but may be secondary to other forms of inflammatory diseases, systemic (general) diseases and occasionally, a disturbed central nervous system (read "brain").
The best treatment for fever is SPONGING. To sponge means to continuously wipe the child's torso and upper half of the legs with a hand towel dipped repeatedly in lukewarm or tap water. Sponging is a serious type of treatment that overcomes the disadvantages of giving medicines; however, it can prove to be difficult if the child is restless or refuses to cooperate. Using lukewarm water helps to get him/her to allow you to remove his/her clothes and to mop the torso without the fear of this causing a chill or any other form of discomfort. Try and keep at the sponging for a time that is proportional to the original temperature rise. Approximately, it takes atleast half an hour of sponging to reduce the temperature by 1-1.5 degrees F. During this procedure, keep giving sips of water or electrolyte rich fluids to the child as he/she feels more thirsty than usual with fever.
Keep monitoring the warmth of the skin by pushing your hand in between the child's back and the mattress; this is one area of skin that is not being sponged and hence reflects the actual fever position. Alternatively, you may check his/her temperature with a thermometer placed in his/her mouth/ear.
If the original temperature is between 99.6 and 102, sponging alone might prove to be effective. If, however, the temperature is higher, you might have to place an ice-bag above his/her head and also administer a fever medicine like paracetamol (Crocin, Adol, Metacin, Calpol) in a dose of 3-6 ml as often as needed (but with an interval of 4-6 hours between successive doses). For older children who are heavier, these brands have adouble strength formulation also available, at least in India, where I live (Crocin DS, Metacin Soorsa, Calpol Plus).
Other effective fever medicines include Mefenamic Acid (Meftal - p, Ponstan), Ibuprofen (Motrin Jr, Ibugesic, Flamar) and Nimesulide (Nise, Nimulid) - the last one being not licensed for use in the U.S.A. and many other developed countries because of the fear of some side-effects.
In addition to the foregoing, let the child rest, eat only light and soft food that is easy to digest and allow him/her to do restful activity like reading, viewing television etc.
However, the most important thing to do is to go as early
Answered at
2:40 PM on April 26, 2008
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