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Feverish Nights

As I sit here holding my feverish baby, I remember as a new mom rushing my 6 month old to the emergency room because my thermometer read 104. Of course when I got there, their thermometer read 102 (I think kids get better once we head to a medical facility or make an appointment). I felt stupid, but it was then that I was introduced to the Ibuprofen/Tylenol combo. Now, as an ER nurse, I see the other side of the situation. I often see frantic parents rushing their kids to the ER with fevers. Although fevers can be very frightening, they are rarely dangerous. Pediatrician Perri Klass states “a fever is a signal that the immune system is working well”.

First fevers are not of serious concern until they reach 106 degrees Fahrenheit or are not coming down with the combined treatment of Ibuprofen and Tylenol. Fevers in infants 3 months and under are always reason for concern, so have these little guys checked out. You can call your pediatrician (even at night they should have someone on call), or call your local ER for questions or advice. Otherwise, we generally don’t treat fevers under 101.0; however, we may treat fevers to ‘treat the parent’. Remember at night and late afternoon fevers will go up.

The first line of treatment for a fever is generally a Tylenol/Ibuprofen combo,  Remember you can give these mediations together – give Tylenol every 4 hours and Ibuprofen every 6 hours. Make sure you are dosing you child correctly. Often, parents under-dose making the drug ineffective. Pediatric medication are dosed based off of weight so it’s good to know your child’s current weight. If you call the ER, ped’s office, or even ask a nurse, have the medicine bottle in hand, there are many different concentrations but they can always give you a correct dose with the correct information. 

Sometimes fevers need a boost to drop or you are very concerned it may not be going down. Other tricks (we even do in the ER) include: first striping them to their underwear/diaper (I know they like being warm and snugly but this is part of the problem), sponge the child and let the water evaporate (often this takes some of the heat from the fever with it), wet his/her hair and let it air dry (a child’s head has a large surface area in ratio to their body this will also take some heat with it). At home you can try a luke-warm bath (not cool- then can be too shocking for the child with a fever). Consider making a doctor appointment because your child may need antibiotics. If the above treatment does not bring a fever down, they need to be seen.

Some other facts about fevers: Only 5% of children are at risk for febrile seizures (these do however run in the family).  Most health care providers worry about dehydration with fevers, so if you child doesn’t want to eat, encourage lots of fluids, water, juice, Gatorade, or Pedialyte. Although I hate my kiddos being sick, I do enjoy the snuggle time because I know someday they will be too big.