The Feverish Child

Managing a child with fever

Fever (a temperature of more than 37⁰C) is a sign of infection or inflammation. In most cases this is likely to be a viral infection. In itself, a fever is a means by which the body fights infection. However, high fevers can precipitate febrile convulsions (seizures), vomiting, loss of appetite and general discomfort.

Seek immediate professional opinion if:

• If you are concerned
• The child is under one month of age
• The fever is persistent for more than 48 hours
• The fever is accompanied by loss of appetite and/or cough and/or discomfort and/or rash
• A fever is not accompanied by some obvious cause within 48 hours e.g. a runny nose, sore throat.
• The child has been travelling to some exotic location
• The child’s temperature cannot be reduced to lowish 37-38⁰C or the child’s demeanour improved (playfulness, appetite) with this reduced temperature

What to do:

You will need:

• A thermometer
• Paracetomol syrup or suppositories
• Nurofen or Ponstan syrup or suppositories
• A fan
• A sponge
• Child’s weight

Step 1: Paracetomol at 15mg/kg/dose every 6 hours for 24- 48 hours (suppository if the child vomits or is reluctant to take medication)

Step 2: Add Nurofen or Ponstan every 8 hours for 24- 48 hours (suppository if the child vomits or is reluctant to take medication)

Step 3: Undress the child: no hats, booties, no synthetic fibres.

Step 4: Reduce the ambient room temperature and humidity (especially in summer): open doors and windows if there no air-conditioner, or set the thermostat to 23-25⁰C

Step 3: if temperature is in the high 38-40⁰C, wet the child’s chest and head with cool (not cold water) using the sponge and let the fan blow over the child. Should the child start shivering, check the temperature. If it’s still higher than high 38⁰C, continue. Stop when the child looks brighter and more playful, usual when the temperature is in the lowish 38⁰C.

Fallacies

Drafts, wet feet, wet hair do not cause cold and flu.

Truisms

Cold and flu are caused by viruses which are around all year. They are able to spread to more people when it’s very hot (and more people are indoors to get into air-conditioning) or when it’s raining and more people are indoors trying not to get wet, or when it’s cold and more people are indoors trying to get warm.