How To Know If You Should Go To The ER For A Fever

If you are otherwise healthy and alert, having a low-grade fever may not necessarily be cause for concern. However, an elevated temperature can be indicative of another process or illness that needs to be treated. A severe or prolonged fever can even cause complications on its own. Because there are a number of possible causes of fever, many of which trigger a similar set of symptoms, it can be challenging to self-diagnose your condition. The expert team of board-certified physicians at both of iCare ER & Urgent Care’s convenient locations in Frisco and Fort Worth, TX provides prompt and reliable evaluation, diagnosis, and treatment for patients presenting with fever. Find out more about the possible causes of fever here, and learn what situations may warrant a visit to the ER for fever.

What is a fever?

For most adults, a normal body temperature is between 97°F and 99°F, though 98.6°F is generally accepted as the standard of normal. When a patient’s body temperature becomes elevated to 100.4°F or higher, he or she is considered to have a fever. Oftentimes, a fever indicates that the body is fighting off a virus, infection, or another pathogen. Common symptoms of a fever include:

• Sweating
• Chills
• Headache
• Body aches
• Fatigue
• Loss of appetite

What causes a fever?

There are a variety of potential reasons why a person’s body temperature may become elevated, either temporarily or for several days or weeks. Some of the most common causes of a fever include:

• Virus
• Infection
• Cold and/or flu
• Stomach bug
• Recent vaccination
• Heat exhaustion

How long does a fever last?

Depending on the cause of the fever, the patient’s overall health, what treatments are given, and other factors, a fever can last anywhere from several hours to several weeks. For some of the most common illnesses, such as the flu, most people demonstrate an elevated temperature for about 2 – 4 days.

How high is too high for a fever?

Fever of 103°F or above is considered high grade and should be treated immediately. However, even a low-grade fever may be a sign of a dangerous problem for infants and babies. If you are concerned about fever in your infant, your child, or yourself, visit your nearest Fort Worth or Frisco emergency room within iCare ER & Urgent Care’s unique dual-hybrid facility.

When should you go to the ER for a fever?

For patients who are otherwise healthy, alert, and have an obvious explanation for their low-grade fever – such as a cold – at-home remedies and monitoring may be sufficient. However, any fever above 103°F should be treated immediately in the ER. In addition, if you or your child are experiencing any of the following symptoms in conjunction with a fever, a trip to the ER is warranted:

• Confusion
• Severe pain (abdominal pain, headache, muscle pain, etc. )
• Sensitivity to light
• Skin rash or irritation
• Protracted nausea or vomiting
• Inability to eat or drink
• Difficulty breathing
• Chest pain
• Seizure
• Inability to stay awake
• Fever of 103°F or higher
• Fever lasting longer than 3 – 4 days (children)
• Any fever (infants)

How is a fever treated in the ER?

To determine the cause of your fever, one of our board-certified ER physicians in Frisco or Fort Worth will perform a thorough examination, take a detailed health history, measure certain vital signs, and possibly draw laboratory studies. Depending on the severity of your condition, the cause of your fever, and other factors, your physician will recommend the most appropriate course of treatment, which may include antibiotics, other medications, fluids, and rest.

Get prompt treatment and rapid relief for your fever by visiting your nearest emergency room in Frisco or Fort Worth, TX

Although some fevers can be treated at home, many cases of fever may indicate a serious problem and should be evaluated immediately. If you are concerned about a high-grade fever or any fever that is accompanied by abnormal or protracted symptoms, visit your nearest iCare ER & Urgent Care center in either Fort Worth or Frisco, TX to be evaluated by one of our professional board-certified physicians for your acute illness and to get the effective treatment and rapid relief you deserve.

How High is Too High? A Guide to Kids’ Fevers (2021 Update)

Throughout your child’s life, one of the most common and worrisome issues that can come up is a fever. You know how the signs begin: chills, a warmer body, and flushed cheeks; but what does your child’s fever mean?

No matter how well or badly your child is feeling, a fever can be a sign that something isn’t quite right. When a fever comes around, that means your child’s body is reacting to an infection or virus; a fever is a sign that your child’s body is fighting back! Even though fevers are a sign of healthy bodies reacting to illness, they definitely can make your child feel lousy.

READ MORE: Guide to Setting Sleep Schedules for Kids

Especially for our youngest patients, who can’t easily say what hurts or that they feel sick, a fever is a clear indicator that they are experiencing sickness or pain. Even as children age, fevers, combined with other symptoms, can be dangerous and must be met with quick medical attention.

But the question remains: what do I do about my child’s fever? With our easy guide below, we help you navigate the highs and lows of fevers, and how to react along the way. As always, contact your pediatrician for specific medical advice for your child. For a general guide to cold and flu season, follow along below:

Best Way to Check a Child’s Temperature

Depending on your child’s age, their temperature can be taken differently, using different thermometers. The fastest and most accurate of all the different kinds of thermometers is the digital thermometer. Most doctors recommend using digital thermometers versus other kinds.

For infants under 3 months of age, the most effective and accurate way to check temperature is rectally, using a digital thermometer. There are two ways to easily take a rectal temperature. With the face down method, place a blanket on your lap, and then lay your baby across your lap, facing downwards. Take your baby’s temperature by using petroleum jelly to insert the thermometer; hold it for 3 minutes to allow the temperature to register. You can also take your baby’s temperature by laying them face up on a firm surface and holding their legs up, with their knees towards their chest. Then proceed to insert the thermometer and get a reading.

You can also take your baby’s temperature under the armpit with a digital thermometer. While not as accurate, this will allow you to get a general idea of if your child has a fever or not. Most daycares and schools will use this method as a general guide if your child has symptoms of being sick.

Fever strips and pacifier thermometers are not usually recommended, as they tend to not be as accurate. We also discourage parents from using glass thermometers, as the mercury inside can poison your child if they are exposed to it.

READ MORE: Guide to Cough Season – What Kind of Cough Does My Child Have?

For older children, you can use a variety of thermometers. The most popular is the digital thermometer, but there are also ones that get a reading by being inserted into the ear or pressed against the forehead. The most accurate way of taking the temperature of an older child is by using a digital thermometer under the tongue. This should be used after your child is 4 years old.

Be aware of what your child has just eaten or had a warm or cold drink when you take their temperature. For example, if your child has a sore throat and just had some soup to ease the pain, wait about 20 minutes for your child to reach his or her resting temperature for the most accurate temperature reading.

Have a Fever? When to Call Your Pediatrician

Depending on your child’s age, there can be different degrees of worry when it comes to fevers. Here is a quick guide for when it is time to call Pediatrics East:

• If your child is under three months old, any fever should be addressed. If his or her temperature is above 100.4 degrees, it is time to call us.
• For children ages three months to three years, call us if there is a fever of 102 degrees or higher.
• For all kids three years and older, a fever of 103 degrees or higher means it is time to call Pediatrics East.
• If a fever of 102 degrees or higher lasts for more than two days, please give us a call, too.

Along with these guidelines, it is important to call Pediatrics East if your baby has not received immunizations and has a fever. Also, please call your pediatrician if your child experiences excessive vomiting or diarrhea, if your child seems dehydrated, or if a serious rash is present with the fever.

READ MORE: Does My Child Have Allergies or a Cold?

If your child is experiencing more severe symptoms with their fever, it does make sense to skip calling Pediatrics East and head to the emergency room. Go to the emergency room in the following circumstances:

• Your child is not breathing or has trouble breathing
• Severe abdominal pain
• Your child has a seizure
• Your child has any other apparent problems, such as swelling or trouble swallowing

Low-grade Fever? What to Do Now

If your child (age six months and older) has a fever that registers above 100.4 degrees and below 102 degrees, you are in a bit of an in-between zone for the first couple of days. While it isn’t necessary to bring your child to Pediatrics East, you will need to keep your child home from daycare or school.

If there are other symptoms in addition to their fever, such as a sore throat, bad cough, or other issues, be sure to monitor the temperature every few hours. If his or her fever begins to rise, it can be a sign of an infection or virus that might need immediate attention. As mentioned above, if a fever persists for several days, give us a call.

Here are the steps you can take to help lower a fever:

• Give Tylenol (infant or kid variety, depending on their age).
• Take a lukewarm bath (not a cold or ice water bath) or a sponge bath.
• Give plenty of fluids, such as water and juices.
• Make sure your child gets plenty of rest.

No Fever, but Still Sick?

Does your child not have a fever, but still appears sick? Monitor his or her symptoms and temperature to determine whether the sickness is getting worse. The best thing you can do for your child is to keep fluids going, feed comforting foods, give lots of love, and call us if symptoms persist or worsen.  To get a better idea of what may be bothering your child, check our Child Illnesses pages to learn more about what your child could be experiencing. Of course, you can always call our office to talk through any concerns or worries you have. 

More Resources

• Guide to Cough Season
• Guide to Ear Infections and Ear Aches
• Tips for Soothing a Fussy Baby
• Bath Time Safety for Kids
• Flu vs. COVID-19

Fever – Humanitas

Fever is usually a signal that something is wrong in the body. In an adult, fever is accompanied by malaise, however, as a rule, a temperature increase of no more than 103 F (39.4 C) is considered harmless. In children of the first days of life and infants, even a slight increase in temperature may indicate the presence of a serious infection.

However, the severity of the fever does not always indicate the severity of the underlying condition. A mild illness may cause a fever with a significant increase in temperature, and a severe illness may be accompanied by a slight increase in temperature.

The fever usually resolves within a few days. A number of over-the-counter drugs can lower a fever, but in some cases it is better not to lower it. An increase in body temperature greatly contributes to the body’s fight against a number of infectious diseases.

Symptoms

Fever is an increase in temperature above normal values. The temperature normal for an individual may be slightly above or below the average normal temperature 98.6 F (37 C).

Fever, depending on the cause, may be accompanied by signs and symptoms such as:

• Sweating
• Trembling
• Headache
• Muscle pain
• Loss of appetite
• Dehydration
• General weakness

Fever 103 F (39.4 C) to 106 F (41.1 C) may cause:

• Hallucinations
• Confusion
• Irritability
• Convulsions
• Dehydration

Conditions requiring medical attention

Fever in itself is not a cause for concern and a reason to seek medical attention. However, there are times when, if you have a fever, you need to see a doctor yourself or take your child to the doctor.

Temperature measurement

Several types of thermometers are suitable for taking your own and your baby’s temperature, including oral, rectal, and ear (tympanic) thermometers.

Although not the most accurate method, an oral thermometer can be used to measure armpit temperature (axillary temperature).

• Place the thermometer in the armpit and cross your arms over your chest.
• Wait four or five minutes. Axillary temperature is slightly lower than oral.
• The doctor who came on call must be informed of the actual readings of the thermometer and name the place where the temperature was taken.

A rectal thermometer is suitable for measuring temperature in young children:

• To do this, grease the bulb of the thermometer with petroleum jelly.
• Place the baby on the stomach.
• Carefully insert the bulb of the thermometer half a centimeter into the child’s rectum.
• Hold the thermometer and child still for three minutes.
• Never let go of the thermometer while it is in the child’s body. If the child wriggles, the thermometer may go deeper and cause damage.

Infants

Unlike adults, unexplained fever in children is a serious cause for concern. If your child’s temperature rises to 101 F (38.3 C) or more, contact your pediatrician. You should also call a doctor in the following cases:

• Fever in a child under 3 months old.
• Refusal of the child to eat and drink.
• Fever and unexplained irritability: the child cries a lot, for example when changing a diaper or at the slightest movement.
• Lethargy and lack of reaction in a child with fever. In infants and children under 2 years of age, these signs may be signs of meningitis, an infection and inflammation of the membranes and fluid surrounding the brain and spinal cord. If meningitis is suspected, the child should be seen by a doctor immediately.
• The body temperature of the newborn is below normal – below 97 F (36.1 C). In the youngest children, during illness, body temperature is difficult to regulate: it may fall rather than rise.

Children

If a child has a fever, but still reacts to others: makes eye contact, responds to facial expressions and voice, then there is probably nothing to worry about.

In the following cases, the child should be taken to the doctor:

• Lethargy or irritability, frequent vomiting, severe headaches or abdominal pain, or any other symptoms that cause severe discomfort.
• Fever after being in a hot car. Seek immediate medical attention if:
• Fever persists for more than one day (in children under 2 years of age) or more than three days (in children 2 years of age and older)

In special cases, for example, if the child has diseases associated with disorders of the immune system or any pre-existing diseases. Doctors also advise caution if a child has recently been prescribed a new drug.

Adults

Seek medical attention if:

• Temperature rises above 103 F (39.4 C)
• Persistence of fever for more than three days

In addition, seek immediate medical attention if any of the following signs or symptoms accompany a fever:

• Severe headache
• Severe swelling of the throat
• Unusual skin rash, especially if it progresses rapidly
• Unusual sensitivity to bright light
• Stiff neck and pain when bending head forward
• Confusion
• Prolonged vomiting
• Labored breathing or chest pain
• Extreme lethargy or excitability
• Abdominal pain or pain when urinating
• Other unexplained signs and symptoms

Complications

Fever may be accompanied by the following complications:

• Severe dehydration
• Hallucinations
• Fever-induced convulsions (febrile convulsions) in a small number of children aged 6 months to 5 years
• Febrile convulsions

Febrile seizures are usually accompanied by loss of consciousness and convulsions of the limbs, involving muscle groups on both sides of the body. Although febrile seizures are a cause of concern for parents, in most cases they do not have any long-term consequences.

If ​​a febrile seizure occurs:

• Place the child on its side or stomach on the floor or other flat surface
• Remove all sharp objects within reach of the child
• Rid the child of tight clothing
• Hold the child to avoid injury.

Do not put anything in the child’s mouth or try to stop seizures
In most cases, seizures go away on their own. After the seizures stop, it is necessary to show the child to the doctor as soon as possible to determine the cause of the fever.

If convulsions persist for more than 10 minutes, seek emergency medical attention.

Appendicitis in children. Causes of occurrence

Appendicitis in children is an emergency condition: if timely medical care is not provided, this can lead to serious complications and death of the child.

The appendix is ​​located at the very beginning of the large intestine and departs from its department, which is called the caecum. Surgery for acute appendicitis – appendectomy – is one of the most common surgical interventions in pediatric surgery.

Often parents use the not entirely correct term “inflammation of appendicitis in a child.” So, before discussing the disease further, remember: “appendix” is an organ, “appendicitis” is inflammation in it.

Acute appendicitis can occur at any age, but is more common in children. Babies under three years old suffer from it relatively rarely. According to the Russian Association of Pediatric Surgeons, the prevalence of pathology in this age group is 8%. The incidence begins to increase after 7 years and peaks at 9-12 years old. In general, acute appendicitis in Russia is diagnosed in 3-6 children out of a thousand per year. It occurs approximately equally in boys and girls. Foreign experts give similar statistics. For example, about 70,000 cases of acute appendicitis are diagnosed annually in the United States. The incidence up to 4 years is 1-4 cases per 10 thousand children, in the group from 10 to 17 years – 25 cases per 10 thousand. Surgeons remove the appendix during a lifetime in 7% of Americans.

Causes

The appendix is ​​a small process of the intestine about 10 cm long. Normally, it is located in the lower right part of the abdomen (the so-called iliac region), but its length and position may vary. Previously, it was considered an “unnecessary” organ, something like an atavism. It is currently known to serve two functions:

• This is the immune organ . The appendix has lymphoid tissue and is like tonsils in the intestines
• The appendix accumulates beneficial bacteria and “reboots” the intestinal microflora after intestinal infections

If you remove the appendix, then this will not affect the functioning of the body and the state of health. Perhaps this is for the best: after all, during acute appendicitis, it is urgent to eliminate the focus of inflammation in order to prevent serious complications.

So what are the main causes of appendicitis in children? Although the disease is very common, the exact causes and mechanisms of its development are not completely clear. There are several theories:

• The obstructive theory states that inflammation develops when the lumen of the process is blocked – most often by hyperplastic lymphoid tissue (similar to enlargement of the adenoids) or dense fecal masses. In turn, dehydration or viral infections can lead to hyperplasia of the lymphoid tissue.
• Infectious theory as the main argument that sometimes cases of acute appendicitis occur in the form of a kind of outbreaks.
• The hereditary theory emerged when it was noted that the risk was likely increased if appendicitis was previously diagnosed in first-line relatives.

The exact cause of the disease is still unclear, but this does not prevent pediatric surgeons from successfully treating acute appendicitis in children.

Pathogenesis

According to the prevailing ideas at the moment, initially the problem is caused by blockage of the appendix. As a result, bacteria begin to multiply in it, and it stretches. It develops venous congestion, ischemia (impaired blood supply). This is what causes inflammation. In turn, it can progress to necrosis and gangrene. There is a perforation of the appendix: a through hole is formed in its wall. This leads to a dangerous condition – inflammation of the sheets of the peritoneum (peritonitis). After a perforation, the symptoms temporarily decrease because the pressure in the appendix is ​​relieved. But this is an imaginary improvement.

As the inflammation in the appendix increases, an inflammatory fluid, an exudate, appears on its surface. It irritates the thin membrane rich in nerve endings inside the abdominal cavity – the peritoneum. Because of this, the pain becomes stronger and localized – it is more clearly felt at the bottom right. And the doctor during the examination of the child detects symptoms of irritation of the peritoneum.

Classification

Appendicitis can be acute or chronic. Most often, doctors have to deal with the former. It is developing rapidly. Chronic appendicitis is an indolent inflammation. In this article, we will mainly talk about acute appendicitis. It is divided into the following types, depending on what changes occur in the appendix:

1. Non-destructive – it is also called simple or catarrhal. In this case, the inflammation is superficial, affecting only the mucous membrane. This type reflects the initial stages of the inflammatory process and is the most difficult to diagnose.

2. Destructive appendicitis is divided into two varieties:

• Phlegmonous – purulent inflammation in the appendix.
• Gangrenous – when necrosis and gangrene are already developing in the wall of the appendix.

In addition, depending on whether complications have developed , two forms of appendicitis are distinguished:

• uncomplicated
• complicated

Symptoms

Pediatric surgeons often list acute appendicitis as one of the simplest and at the same time one of the most difficult diagnoses. Indeed, it can hide under the guise of a number of other diseases. If the doctor has doubts, then he is in no hurry to immediately perform an appendectomy, but leaves him in the clinic for a while and monitors his condition. If the symptoms intensify and the clinical picture becomes clear, an operation is performed immediately.

It is important for parents to know that some “special” signs of appendicitis in children are not so much important as the order in which symptoms appear:

1. Usually abdominal pain starts first . At first, the child cannot say exactly where she is bothering. At an older age, after some time, the pain usually “descends” to the right iliac region, and in a small child, the entire abdomen or the area around the navel may hurt all the time. Appendicitis pain in infants is difficult to recognize, because they cannot tell what is bothering them. Instead, the child becomes capricious, refuses to eat, does not allow touching the stomach.

2. Pain is followed by such symptoms as refusal to eat, nausea, vomiting .

3. If after this the adults try to feel the belly of the child , then it turns out to be very painful for him .

4. Subsequently, the temperature rises – usually from 37.7 to 38.3 ° C.

Symptoms of appendicitis in teenagers are easier to recognize because they are more obvious, and at an older age the child can talk more about them.

Often, acute appendicitis must be distinguished from viral gastroenteritis, and in these diseases the sequence is different: vomiting usually appears first, and only after it, abdominal pain and frequent loose stools. But self-diagnosis in any case should not be done. Seek immediate medical attention .

When should I see a doctor?

With the symptoms listed above, it is better to immediately consult a doctor, and if the child feels very unwell, call an ambulance. Intense and increasing pain in the abdomen should be especially alert. If the symptoms are not strong, you can contact a pediatrician: if a child has manifestations of the so-called acute abdomen, he will immediately invite a pediatric surgeon to examine him.

Possible complications

If timely surgical treatment is not carried out, then the appendix can rupture, and this will lead to one of two complications:

• Abscess – limited accumulation of pus and infection in the abdominal cavity
• Peritonitis – diffuse inflammation in the abdominal cavity

The likelihood that the appendix will rupture is very high: this occurs in about 90% of children under two years of age and 65% of children under five years of age. The risk of appendix perforation in children within 24 hours from the onset of the first symptoms, according to some reports, is 7.7%, and within 72 hours this will happen with almost one hundred percent probability.

Diagnostic methods

Acute appendicitis is mostly a clinical diagnosis. The doctor installs it after examining the child. He palpates (feels) the abdomen, reveals soreness, tension in the muscles of the press, symptoms of irritation of the peritoneum. The most famous of these symptoms, which is taught first of all to all medical students, is the Shchetkin-Blumberg symptom.

If you slowly press your fingers on the abdominal wall, and then release it sharply, this leads to the fact that the irritated sheets of the peritoneum “peel off” from each other, and there is a strong pain sensation.

A general blood test is prescribed: an elevated level of leukocytes is found in it.

Diagnosis of appendicitis in children is often difficult, because its symptoms often hide diseases such as viral gastroenteritis, intestinal intussusception, Crohn’s disease, Meckel’s diverticulum, pancreatic (pancreatic) colic, familial Mediterranean fever.

If the diagnosis is unclear, then diagnostic methods such as ultrasound of the abdominal organs, computed tomography, and magnetic resonance imaging can be prescribed. As we mentioned above, with an unclear clinical picture, the surgeon can leave the child in the hospital for a while, observe him, and prescribe antibiotics.

In case of strong doubts, the surgeon will most likely decide to operate, and rightly so: it is better to play it safe than to do nothing and thereby endanger the life of the patient. Also, in doubtful cases, diagnostic laparoscopy can be performed: the doctor inserts an instrument with a video camera (laparoscope) into the abdominal cavity through a puncture, examines it, and this helps to figure out if there is a need for an operation.

Methods of treatment

Acute appendicitis is treated by removing the appendix – appendectomy . It is cut off at the base, and the hole remaining in the intestine is closed with a purse-string suture. Such an operation is carried out on an emergency basis. Classically, it is performed through a small oblique incision in the right iliac region, but modern surgeons are increasingly resorting to laparoscopic interventions – through punctures in the abdominal wall. The operation can last from 30 minutes to 1.5 hours. Every pediatric surgeon knows how to perform it – usually this is the very first intervention, which is taught to beginner doctors in this specialty.

If the appendicitis was uncomplicated, then the child spends one night in the hospital, and he is discharged home. If the appendix was perforated, then you will have to spend about five days in the clinic and receive antibiotic treatment.

Forecast

If treatment is carried out in a timely manner, then the prognosis is usually favorable. 0.1% of children die (one in a thousand), in 3% of cases after surgery, certain complications develop. If the operation is performed after the rupture of the appendix, then the complication rate is 10-15%. Such situations are most common in children under two years of age, since it is more difficult to diagnose the disease in them in a timely manner.

Prevention

Since the causes of the development of the disease are not fully understood, there is no special prevention of appendicitis. A complete healthy diet with a predominance of plant products is recommended, as well as prevention of constipation. Antibiotics should not be used uncontrollably.

Main

• Acute appendicitis is an inflammation of the appendix and is one of the most common surgical diseases in children.
• The causes of the disease are not fully known. It is believed that the obstruction of the appendix with dense fecal masses and hyperplastic (increased in volume) lymphoid tissue plays an important role.
• The main manifestations of acute appendicitis: abdominal pain, nausea, vomiting, fever. But they are nonspecific and are found in many other diseases.