Clinical Reference Systems: Pediatric Advisor 10.0

Description

A fever means the body temperature is above normal. You have a fever if your oral temperature is over 99.5ƒF (37.5ƒC).

The body's average temperature when it is measured orally is 98.6ƒF (37ƒC), but it normally fluctuates during the day. Mild elevation (100.4 to 101.3ƒF, or 38 to 38.5ƒC) can be caused by exercise, excessive clothing, a hot bath, or hot weather. Warm food or drink can also raise the oral temperature. If you suspect such an effect on your temperature, take it again in a half hour.

Taking the Temperature

1. Taking oral temperatures
   • Shake the thermometer until the mercury line is below 98.6ƒF (37ƒC).
   • Place the tip of the thermometer under one side of your tongue.
   • Hold it in place with your lips and fingers (not your teeth) and breathe through your nose, keeping your mouth closed.
   • Leave it inside for 3 minutes.
   • After 3 minutes, take the thermometer out of your mouth. Find where the mercury line ends by rotating the thermometer until you can see the mercury and read the temperature.

2. Conversion of degrees Fahrenheit (F) to degrees centigrade (C)

    
                 98.6ƒF = 37.0ƒC 
                100.0ƒF = 37.8ƒC 
                100.4ƒF = 38.0ƒC 
                101.0ƒF = 38.3ƒC 
                102.0ƒF = 38.9ƒC 
                103.0ƒF = 39.5ƒC 
                104.0ƒF = 40.0ƒC 
                105.0ƒF = 40.6ƒC 
                106.0ƒF = 41.1ƒC 
                107.0ƒF = 41.7ƒC 
   

CAUSES

Fever is a symptom, not a disease. It is the body's normal response to infections. Fever helps fight infections by turning on the body's immune system. The usual fevers (100 to 104ƒF, or 37.8 to 40ƒC) are not harmful. Most are caused by viral illnesses; some are caused by bacterial illnesses.

EXPECTED COURSE

Most fevers with viral illnesses range from 101 to 104ƒF (38.3 to 40ƒC) and last for 2 to 3 days. In general, the height of the fever doesn't relate to the seriousness of the illness. How sick you feel is what counts. Fever causes no permanent harm until it reaches 107ƒF (41.7ƒC). Fortunately, the brain's thermostat keeps untreated fevers below this level.

HOME CARE

1. Extra fluids and less clothing

   Drink extra fluids. Iced drinks are especially helpful. Body fluids are lost during fevers because of sweating.

   Clothing should be kept to a minimum because most heat is lost through the skin. During the time you feel cold or are shivering (the chills), wrap yourself in a light blanket.

2. Acetaminophen

   Take any one of the acetaminophen products: Tylenol, Anacin-3, Panadol, or Tempra. The dosage is 2 tablets (650 mg) every 4 to 6 hours.

   Remember that fever is helping your body fight the infection. Take drugs only if your fever is over 102ƒF (39ƒC) and preferably only if you are also uncomfortable.

   Two hours after they are taken, these drugs will reduce the fever 2ƒ to 3ƒF (1ƒ to 2ƒ C). Medicines do not bring the temperature down to normal unless the temperature was not very elevated before the medicine was given. Repeated dosages of the drugs will be necessary because the fever will go up and down until the illness runs its course.

3. Ibuprofen

   Ibuprofen is available in 200-mg tablets without a prescription as Advil, Motrin, etc. The dosage is two tablets (400 mg) of ibuprofen every 6 to 8 hours. When you use ibuprofen, stop taking acetaminophen.

4. Avoid aspirin

   The American Academy of Pediatrics recommends that children (through age 21 years) not take aspirin if they have chickenpox or influenza (any cold, cough, or sore throat symptoms). This recommendation is based on several studies that have linked aspirin to Reye's syndrome, a severe encephalitis-like illness. Most pediatricians have stopped using aspirin for fevers associated with any illness.

Call Your Physician Immediately If:

• Your fever is over 105ƒF (40.6ƒC).
• You feel very sick.

Call Your Physician Within 24 Hours If:

• Your fever is between 104ƒ and 105ƒF (40ƒ to 40.6ƒC).
• Your fever went away for more than 24 hours and then returned.
• You have a fever for more than 3 days.
• You have other concerns or questions.