Fever

Fever is the body’s response to various illnesses (usually infections).  Temperatures 100.5*F (38.1*C) or above are considered fevers.  When reporting fevers, be able to tell the nurse how many hours your child has had a fever.  We recommend a cheap digital thermometer as most accurate and consistent means to check core body temperature. 

How to take a temperature…

The most accurate temperature for all infants (under 3 months old) is a rectal temperature.

Taking a Rectal temperature: You may lubricate the end of a digital thermometer.  Place about a half inch into rectum until thermometer keeps.

Taking an Oral temperature: This method should only be used if your child can hold the thermometer in the mouth with the mouth closed.  Be sure that your child has not recently had anything hot or cold to drink.

Place the thermometer tip under the tongue and close the mouth.

Taking an Axillary temperature (armpit): Place the tip of the thermometer in the armpit, and close the armpit by holding the elbow against the chest. 

Automated ear thermometer: Ear thermometers are not recommended due to errors with accuracy and inconsistency.

 During office hours if:

• Your child has a fever and burning or pain with urination
• Your child has a fever lasting more than 72 hours
• You have further questions

 Immediately if:

• Your child has a fever of 100.5*F (38.0*C) or more and your child is less than 2 months of age (unless your baby has had shots in the previous 48hrs.)
• Your child has a fever over 105*F (40*C)
• Your child has a fever over 101* and is crying inconsolably despite pain medication (for children over 2 months of age)
• Your child is difficult to awaken
• Your child is confused or delirious
• Your child has had a seizure
• Your child has a rash of purple spots that look like bruises
• Your child has a stiff neck and has a fever. They should not have pain at the back of their neck when stretching chin to chest.
• Your child has a fever and is anxious and drooling because he cannot swallow.  This does not apply to drooling babies.
• Your child has a fever and additional risk factors such as: sickle cell anemia, cancer, asplenia, or immune deficiency.
• Your child has a fever and has bloody diarrhea.

 The object of treating children when they have a fever is to try to make them comfortable.  The fever itself does no harm. Dress the child in a way that makes them comfortable.  If they are flushed, hot and sweaty, they should wear less.  If they are cold and shivery, they should wear more.  Infants should not be bundled when they have a fever.

  Medications are given for comfort

• They are not given to control the fever
• You do not need to wake a child to give fever medication       
• Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) can be used.  Do not give Aspirin to children.                                 

 Acetaminophen Dosage Chart Since 2012, acetaminophen liquid has only one strength

Acetaminophen (Tylenol or another brand)

Give every 4-6 hours as needed. (Also available in suppositories; use the same number of mg.)

*Do not give more than 4 doses in 24 hours.

Weight in pounds (lbs.)	Elixir 1 teaspoon =   160mg/5ml	Chewable 1 tablet = 80 mg	Jr. Strength 1 caplet = 160 mg	Reg. Strength 1 tablet = 325 mg
6-11 lbs.	¼ teaspoon (1.25   ml)	------	-------
12-17 lbs.	½ teaspoon   (2.5ml)	------	-------
18-23 lbs.	¾ teaspoon (3.75   ml)	------	-------
24-35 lbs.	1 teaspoon (5 ml)	2 tablets	-------
36-47 lbs	1 ½ teaspoons   (7.5 ml)	3 tablets	-------
48-59 lbs.	2 teaspoons (10   ml)	4 tablets	2 caplets	1 tablet
60-71 lbs	2 ½ teaspoons   (12.5 ml)	5 tablets	2 ½ caplets	1 tablet
72-95 lbs	3 teaspoons (15   ml)	6 tablets	3 caplets	1 ½ tablets
96+ lbs.	-------	------	4 caplets	2 tablets

 

Ibuprofen (Advil, Motrin, or another brand.)

Give every 6 to 8 hours as need: always with food. Other strengths available by prescription.

*Do not give more than 4 doses in 24 hours.

Weight in pounds (lbs.)	Dose	Liquid 1 teaspoon = 100   mg/5ml	Chewable Tablets 1 tablet = 100 mg	Tablets 1 tablet = 200 mg
11-21 lbs.	50 mg	½ teaspoon (2.5   ml)	½ tablet
22-32 lbs.	100 mg	1 teaspoon (5 ml)	1 tablet
33-43 lbs.	150 mg	1 ½ teaspoons   (7.5 ml)	1 ½ tablet
44-54 lbs.	200 mg	2 teaspoons (10   ml)	2 tablets	1 tablet
55-65 lbs.	250 mg	2 ½ teaspoons   (12.5 ml)	2 ½ tablets
66-87 lbs.	300 mg	3 teaspoons (15   ml)	3 tablets	1 ½ tablets
88+ lbs.	400mg	4 teaspoons (20   ml)	4 tablets	2 tablets

                                               

Additional Information:

• Fever does not cause brain damage.  Some of the infections that cause fever such as meningitis and encephalitis can cause brain damage.  The advice under the When to Call section will alert you to the presence of these types of infections.
• Fever is not a disease, it is the body’s response to help fight off an illness.
• It is notnecessary to get the fever down.  With many common illnesses the fever will not come all the way down even after medication for the fever.
• Except with babies it is not necessary to know the exact temperature nor is it necessary to know the temperature at all times.  If your child is over 3 months and is acting fine, you don’t need to take the temperature at all.
• We are often asked, “When should a parent worry about a fever?” The section of when to call outlines the conditions under which there is concern if your child has a fever.
• Sponging is rarely necessary.  Never sponge your child before giving acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) first.  Sponging or cool baths can be used if your child says he is too hot. Sponging or cool baths should be used in emergencies such as heat stroke or delirium.
• You should encourage but not force your child to drink when there is a fever.  The fever causes additional fluid losses.  A child who is dehydrated (low on fluids) will want to drink.
• We treat fevers if the child is uncomfortable with the fever.  The child frequently has aches when there is a fever, and pain and fever medication can help reduce those aches.  If your child has a fever but feels “ok”, no treatment is needed.