Fever Care For Children | Children’s Hospital Colorado

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• An abnormal high body temperature
• Fever is the only symptom. Your child has a true fever if:
• Rectal (Bottom), Ear or Forehead temperature: 100.4° F (38.0° C) or higher
• Oral (Mouth) temperature: 100° F (37.8° C) or higher
• Under the arm (Armpit) temperature: 99° F (37.2° C) or higher
• Caution: Ear temperatures are not accurate before 6 months of age
• Caution: Forehead temperatures must be digital. Forehead strips are not accurate.

Causes of Fever

• Overview. Almost all fevers are caused by a new infection. Viruses cause 10 times more infections than bacteria. The number of germs that cause an infection are in the hundreds. Only a few common ones will be listed.
• Viral Infections. Colds, flu and other viral infections are the most common cause. Fever may be the only symptom for the first 24 hours. The start of viral symptoms (runny nose, cough, loose stools) is often delayed. Roseola is the most extreme example. Fever may be the only symptom for 3 to 5 days. Then a rash appears.
• Bacterial Infections. A bladder infection is the most common cause of silent fever in girls.
• Sinus Infection. This is a problem caused by a cold. The main symptom is the return of fever after it has been gone for a few days. The sinus congestion also changes to sinus pain. Color of nasal discharge is not very helpful for making this diagnosis.
• Vaccine Fever. Fever with most vaccines begins within 12 hours. It lasts 2 to 3 days. This is normal and harmless. It means the vaccine is working.
• Newborn Fever (Serious). Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment.
• Meningitis (Very Serious). A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Younger children are lethargic or so irritable that they can’t be consoled. If not treated early, can suffer brain damage.
• Overheated. The fever is usually low grade. Can occur during heat waves or from being overdressed. The temp becomes normal in a few hours after moving to a cooler place. Can also occur during hard exercise. Fever goes away quickly with rest and drinking extra fluids.
• Not Due to Teething. Research shows that “getting teeth” does not cause fevers.

Fever and Crying

• Fever on its own shouldn’t cause much crying.
• Frequent crying in a child with fever is caused by pain until proven otherwise.
• Hidden causes can be ear infections, kidney infections, sore throats and meningitis.

Roseola: Classic Cause of Unexplained Fever in Young Children

• Most children get Roseola between 6 months and 3 years of age.
• Cause: human herpes virus 6
• Rash: pink, small, flat spots on the chest and stomach. Rash is the same on both sides of the body.
• Then spreads to the face.
• Classic feature: 2 or 3 days of high fever without a rash or other symptoms.
• The rash starts 12 to 24 hours after the fever goes away.
• The rash lasts 1 to 3 days.
• By the time the rash appears, the child feels fine.

Normal Temperature Range

• Rectal. A reading of 98.6° F (37° C) is just the average rectal temp. A normal low can be 96.8° F (36° C) in the morning. It can change to a high of 100.3° F (37.9° C) late in the day. This is a normal range.
• By mouth. A reading of 97.6° F (36.5° C) is just the average mouth temp. A normal low can be 95.8° F (35.5° C) in the morning. It can change to a high of 99.9° F (37.7° C) late in the day. This is a normal range.

Call 911 Now

• Not moving or too weak to stand
• Can’t wake up
• Severe trouble breathing (struggling for each breath; can barely speak or cry)
• Purple or blood-colored spots or dots on skin
• You think your child has a life-threatening emergency

Go to ER Now

• Stiff neck (can’t touch chin to the chest)
• Age less than 1 year and soft spot bulging or swollen
• Hard to wake up
• Had a seizure with the fever
• Not alert when awake (“out of it”)
• Acts or talks confused

Call Doctor or Seek Care Now

• Trouble breathing, but not severe
• Great trouble swallowing fluids or spit
• Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
• Fever over 104° F (40° C)
• Shaking chills (shivering) lasting more than 30 minutes
• Nonstop crying or cries when touched or moved
• Won’t move an arm or leg normally
• Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
• Pain or burning when passing urine
• Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Age 3-6 months old with fever
• Age 6-24 months old with fever that lasts more than 24 hours. There are no other symptoms (such as cough or diarrhea).
• Fever lasts more than 3 days
• Fever returns after being gone more than 24 hours
• Recent travel outside the country to high risk area
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Fever with no other symptoms and your child acts mildly ill

Care Advice for Fever

1. What You Should Know About Fever:
   • Having a fever means your child has a new infection.
   • It’s most likely caused by a virus.
   • You may not know the cause of the fever until other symptoms develop. This may take 24 hours.
   • Most fevers are good for sick children. They help the body fight infection.
   • Use the ranges below to help put your child’s level of fever into perspective:
   • 100° – 102° F (37.8° – 39° C) Low grade fever: helpful, good range. Don’t treat.
   • 102° – 104° F (39 – 40° C) Average fever: helpful. Treat if causes discomfort.
   • Over 104° F (40° C) High fever: causes discomfort, but harmless. Always treat.
   • Over 106° F (41.1° C) Very high fever: important to bring it down. Rare to go this high.
   • Over 108° F (42.3° C) Dangerous fever: fever itself can be harmful.
2. Treatment for All Fevers – Extra Fluids
   • Fluids alone can lower the fever. Reason: being well-hydrated helps the body give off heat through the skin.
   • Offer your child extra water or other fluids by mouth. Cold fluids are better. Until 6 months old, only give extra formula or breastmilk.
   • For all children, dress in 1 layer of light weight clothing, unless shivering. Reason: also helps heat loss from the skin.
   • For shivering (or the chills), give your child a blanket. Make them comfortable.
   • Caution: if a baby under 1 year has a fever, never overdress or bundle up. Reason: babies can get over-heated more easily than older children.
3. Fever Medicine:
   • For fevers 100°-102° F (37.8° – 39°C), fever meds are not needed. Reason: fevers in this range help the body fight the infection. Fevers turn on the body’s immune system. Fevers do not cause any discomfort.
   • Fever meds are mainly needed for fevers higher than 102° F (39° C).
   • Give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Goal of treatment: keep the fever at a helpful level. Most often, the fever meds lower the fever by 2° to 3° F (1 – 1. 5° C). They do not bring it down to normal. It takes 1 or 2 hours to see the effect.
   • Do not use aspirin. Reason: risk of Reye syndrome, a rare but serious brain disease.
   • Do not use both acetaminophen and ibuprofen together. Reason: not needed and a risk of giving too much.
   • Pain: fever does not cause pain. If your child also has pain, it’s from the infection. It may be a sore throat or muscle pain. Treat the pain, if it’s more than mild.
4. Sponging with Lukewarm Water:
   • Note: sponging is an option for high fevers, but not required. It is rarely needed.
   • When to Use: fever above 104° F (40° C) AND doesn’t come down with fever meds. Always give the fever medicine at least an hour to work before sponging.
   • How to Sponge: use lukewarm water (85 – 90° F) (29.4 – 32.2° C). Sponge for 20-30 minutes.
   • If your child shivers or becomes cold, stop sponging. Other option: you can also make the water warmer.
   • Caution: do not use rubbing alcohol. Reason: can cause a coma.
5. Return to School:
   • Your child can return to school after the fever is gone. Your child should feel well enough to join in normal activities.
6. What to Expect:
   • Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C).
   • They may last for 2 or 3 days.
   • They are not harmful.
7. Call Your Doctor If:
   • Your child looks or acts very sick
   • Any serious symptoms occur such as trouble breathing
   • Fever goes above 104° F (40° C)
   • Any fever occurs if less than 12 weeks old
   • Fever without other symptoms lasts more than 24 hours (if age less than 2 years)
   • Fever lasts more than 3 days (72 hours)
   • You think your child needs to be seen
   • Your child becomes worse

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

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When to Go to the ER with a Fever

What Is a Fever?

The term “fever” gets tossed around a lot, but the details of what a fever does for your body are not often discussed. A fever is usually a symptom of an underlying condition or infection. The part of your brain called the hypothalamus is responsible for controlling body temperature, and the normal body temperature lies at around 98.6°F or 37°C.

A fever occurs when your body is trying to kill a virus or bacteria that causes an infection. This is because a higher temperature makes the body a less welcoming host for replicating viruses and bacteria. A mild fever is a good indication that your immune system is doing its job, but fevers are not always brought on by infections. Other potential causes of fever include amphetamine abuse, alcohol withdrawal and environmental fevers like heat stroke.

When Should You Go to the ER for a Fever?

While it’s true that a fever typically means your immune system is hard at work, the fever can sometimes raise to unhealthy levels. When the body temperature exceeds 105°F, it exposes the proteins and body fats to temperature stressors that can interfere with their functioning. Prolonged exposure can lead to cellular stress, infarctions, necrosis, seizures and delirium.

To prevent these conditions from occurring, here are some signs that a fever warrants a trip to the ER.

For an Infant Younger than 90 Days Old

• If changes in appetite are occurring along with the fever, you should seek emergency care.
• If changes in behavior or sleeping patterns accompany the fever, you should seek emergency care.
• If diarrhea or vomiting are occurring along with the fever, you should seek emergency care.
• If your infant is constipated and has a fever, you should seek emergency care.
• If your infant has a cold and a fever, you should seek emergency care.
• If your infant has a rash or skin discoloration and a fever, you should seek emergency care.
• If your infant has eye discharge, you should seek emergency care.
• If your infant is having difficulty waking up to feed alongside a fever, you should seek emergency care.
• If your infant is having difficulty breathing, you should seek emergency care.

For a Baby Between the Ages of 90 Days and 36 Months Old

• If your baby is experiencing any of the symptoms above alongside a fever, you should seek emergency care.
• If your baby is not immunized and has a fever, you should seek emergency care.

For a Child Older than 36 Months Old

• If your child is experiencing any of the symptoms above alongside a fever, you should seek emergency care.
• If your child is experiencing abdominal pain and has a fever, you should seek emergency care.
• If your child is communicating feelings of persistent discomfort alongside a fever, you should seek emergency care.

For an Adult

• If an adult is experiencing a painful headache and has a fever, they should seek emergency care.
• If an adult is experiencing abdominal pain and has a fever, they should seek emergency care.
• If an adult is having difficulty breathing or chest pain accompanied by a fever, they should seek emergency care.
• If an adult has a compromised immune system and comes down with a fever, they should seek emergency care.
• If an adult has had chemotherapy recently and has a fever, they should seek emergency care.
• If the adult’s fever lasts for more than three days, they should seek emergency care.
• If the adult’s fever rises above 103°F, they should seek emergency care.
• If the adult’s fever is accompanied by nausea, confusion or a rash, they should seek emergency care as these symptoms may be caused by meningitis.
• If the adult’s fever is accompanied by confusion, a rapid heartbeat or dizziness, they should seek emergency care as these may be signs of a heat stroke.

Please note that these lists are not all-inclusive. If you are doubtful that the fever will resolve on its own, it is best to have the condition examined by a medical professional.

What Will Advance ER in Dallas Do for a Fever?

At Advance ER, we offer top quality medical care 24/7, with emergency professionals who are experienced in treating all age groups. We are dedicated to giving every patient the best care available, and will work diligently to identify the cause of the fever and treat the underlying condition. Whether you are concerned about your child, a loved one or yourself, you can trust our integrative, advanced approach to health and wellness.

If you would like to learn more about Advance ER, please give us a call at (214) 494-8222, or find us online.

At what temperature to call an ambulance for a child and an adult – September 17, 2022

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Sometimes calling an ambulance is not necessary – just drink paracetamol

Photo: Elena Latypova / NGS55.RU

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When it comes to calling a doctor, some are afraid to disturb the doctor once again, while others are ready to call an ambulance as soon as the thermometer shows 37. 5. Doctors don’t always help either: someone asks why they called, someone asks why they didn’t call earlier? We talked with doctors to put an end to this issue: at what temperature should you call an ambulance, when to call a doctor, and in which case just drink an antipyretic and not bother anyone.

In fact, there is no bar by which you can say: if the temperature is 0.1 degrees higher, it’s time to call an ambulance. Other symptoms may also be decisive.

– An ambulance is called when the temperature is febrile – that is, above 38.5 and is not dropping well, – says infectious disease doctor Andrey Pozdnyakov. – An ambulance is called when the temperature is accompanied by some other symptoms similar to life-threatening ones. The most striking is convulsions, impaired consciousness, severe tachycardia. An ambulance should be called according to the totality of symptoms, the temperature is not necessarily one of them.

Andrey Pozdnyakov — infectious disease specialist, candidate of medical sciences, chief physician of the clinical diagnostic laboratory “Invitro-Siberia”.

An adult needs an ambulance for hyperthermic reactions, that is, a very high temperature.

“If the temperature is above 40, then an ambulance is definitely needed, because it is fraught with serious consequences,” says therapist Ivan Skorokhodov. – If the temperature persists for a long time. If you have covid or you suspect that it is him, then if there are risk factors, a fever for more than three days is a reason to call an ambulance. If, in addition to temperature, you have abdominal pain, frequent loose stools is a suspicion of an intestinal infection, if the pain is intense, this may be a surgical pathology.

Ivan Skorokhodov — practicing therapist, allergist-immunologist. Member of the Russian Association of Allergists and Immunologists.

For children, the rules are slightly different: a temperature above 39 in a child is already a risk of seizures. With an acute appearance of temperature in a child, an ambulance is called in any case.

The polyclinic always has a doctor on duty who sees patients. You can turn to him if you feel unwell, but there is no reason to call an ambulance. However, with a temperature, it is still not worth going to the clinic.

— Let’s be honest and correct: from the point of view of epidemiology, it does not matter what disease caused the fever – covid, not covid, most often it is an acute respiratory infection. Accordingly, in order not to infect others, in principle, you don’t need to go to the clinic,” says Andrey Pozdnyakov. – If it is clear that this is a respiratory infection and the person is an adult, without any risk groups, then try to lower the temperature yourself and call a doctor as planned. In any case, you do not need to go to the clinic at a temperature.

As you might have guessed from the previous point, whenever you have a fever. If you do not notice anything unusual in your condition, you can try to cope on your own – antipyretic, vasoconstrictor drops, lozenges or tablets for sore throat. It is worth taking an antipyretic at a temperature above 38.5 degrees, but if the temperature is lower, and you still feel unwell, it is not necessary to endure the malaise.

– Temperature is just a symptom of the immune system and the development of inflammation. Some people do not tolerate inflammation well, they have a so-called flu-like syndrome: weakness, malaise, aches, pain in the joints, muscles, headaches, eyes hurt and fever, says Ivan Skorokhodov. – In fact, this is the response of the body to the introduction of an infection, for some it is more, for others it is less. The drugs we take when we have a temperature block this excess inflammation and we feel better accordingly.

The doctor emphasizes that if you see that the temperature does not go away, symptomatic therapy with over-the-counter drugs does not help for three days – this also requires a doctor’s call.

If you cannot stay at home with a fever, call your doctor to take sick leave. During a pandemic, all patients with symptoms of SARS are considered suspicious for covid, so it’s better to play it safe and not cough on others. How sick leave is now issued for covid and colds, we talked about in this material, and here you can read about how it is paid.

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What should I do if the temperature is 39 degrees, the temperature is 38–39 degrees and symptoms of SARS, where to call – July 11, 2021

I have a temperature of 39. In how many hours will the doctors arrive? Will they take you to the hospital? Let’s figure it out together

• 1. Where should I call if I have a high temperature?
• 2. When will the doctor arrive?
• 3. Will they take me to the hospital with a temperature of 38–39?
• 4. What if I don’t know who to call?
• 5. I have an atypical case. How to be?

1

Who to call with a high temperature?

– If you have a temperature, you do not need to call an ambulance. Such calls (uncomplicated temperature) are still transferred by ambulance to polyclinics, they say in the Ministry of Health.

What if the temperature rises to dangerous 40-41 degrees? The head physician of the ambulance, Irina Bolshakova, assures that the matter is not in the numbers, but in the accompanying symptoms and the presence of chronic diseases, which the dispatcher learns about.

– In case of a significant deterioration in the condition, it is necessary to contact an ambulance. All dispatchers are doctors: they will assess the patient’s condition according to the checklist and decide whether hospitalization is necessary. Recall that infectious ambulance teams provide emergency care, as well as transport patients to hospitals. Outpatient treatment, if hospitalization is not required, is prescribed by a medical worker of the polyclinic, the Ministry of Health explains.

So at a temperature of 38-39 degrees, you need to call a doctor from the clinic, but the easiest way to do this is through your personal account on the State Services website:

– All calls are received by the polyclinic and processed regardless of the method of calling the doctor: “Public Services”, Unified Registry 124, call center of the polyclinic, unified telephone numbers 122 and 112.

The Ministry of Health says that employees of polyclinics are doing their best to process calls to house during the day . But Deputy Minister of Health Elena Aksenova honestly admits: the situation related to the coronavirus is tense, and the burden on the healthcare system, especially on primary care, is large:

— Unfortunately, it happens that doctors do not have time to visit a patient due to a high workload, but we set the task to complete this call within a day. We are developing telemedicine consultations and audio monitoring so as not to leave the patient alone. Stories when a patient waited for a doctor for three days, did not get through to the clinic, we work out, analyze and correct. Believe me, this is also a big problem for us, and we are doing our best.

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3

Will they take me to the hospital with a temperature of 38–39?

— Indications for hospitalization are determined by a medical worker individually, after examination. If the doctor sends the patient for hospitalization, then it is necessary to call an ambulance and wait for the arrival of the brigade. The ambulance dispatcher determines the order of transportation to the hospital, taking into account the severity of the patients’ condition, the Ministry of Health says.

Patients with suspected or confirmed COVID-19 are admitted to infectious diseases hospitals only for medical reasons. Doctors also make the decision to hospitalize each patient individually, after additional examination, taking into account not only the severity of the current condition, but also the history and other related factors.

— Thus, there are no standard criteria for admission to hospital, regardless of whether or not the patient has PCR test results for the novel coronavirus infection COVID-19. Age over 60 years is not an unequivocal indication for hospitalization of patients with suspected and confirmed COVID-19, the NSO Ministry of Health explains.

Chief ambulance doctor Irina Bolshakova adds that the temperature itself is not a reason to call an ambulance. It is necessary that the local doctor prescribes treatment, because a single decrease in the temperature by an ambulance with an injection does not have an effect. It is the same with hospitalization: after the examination, the doctor from the clinic will determine whether there are indications for this.

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4

What if I don’t know who to call?

You should think about calling an ambulance if you have shortness of breath, a high temperature does not fall and increases for several days, or some other symptoms are added. But, according to the chief physician of the ambulance, there is no single answer for everyone, because the help of a medical officer is needed.

That is, if there are other symptoms besides fever, the patient can call an ambulance and describe his condition. The dispatcher will ask questions, navigate by the answers, and then decide whether to transfer the call to the clinic or leave it.

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5

I have an atypical case. How to be?

If you are waiting for a doctor for an abnormal number of days (for example, a week or more) or if your case differs in some way from other similar situations, please contact the editors of the NHS and tell your story.

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