Microsoft word - fever management 11-2006.doc

FEVER MANAGEMENT IN CHILDREN

DESCRIPTION- A fever means the body temperature is above normal. Your child has a fever if his:
axillary (armpit) temperature is over 99.00 F The body’s average temperature when it is measured orally is 98.60 F, but it normally fluctuates during the
day. Mildly increased temperature (100.4 to 101.30 F) can be caused by exercise, excessive clothing, a hot
bath or hot weather. Warm food or drink also can raise the oral temperature.
CAUSES: Fever is a symptom, not a disease. It is a normal response to infections. Fever helps fight
infections by turning on the body’s immune system. The usual fevers (100 to 1050 F), which all children get,
are not harmful. Most fever with viral illnesses last for only 2 to 3 days.
HOME CARE
1. Acetaminophen. You can give acetaminophen (Tylenol®, Tempra®, generics) to children older than two
months. Remember that fever is helping your child fight the infection. Use drugs only if the fever is over 1020 F and preferably only if your child also is uncomfortable. Fever medicine usually lowers the fever by 2-30 F. See the charts on the back of this page for your child’s dose. Give every 4 to 6 hours, as needed. 2. Ibuprofen. You may also give ibuprofen (Advil®, Motrin®, generics) to children older than 6 months.
Ibuprofen reduces fever as well as acetaminophen. See the charts on the back of this page for your
child’s dose. Give every 6 to 8 hours, as needed.
Note: You should use either acetaminophen or ibuprofen, but not both. We do not recommend
giving both acetaminophen and ibuprofen (either at the same time or alternating) for fever
management.

3. Avoid aspirin. The American Academy of Pediatrics recommends that children (through age 21 years)
not take aspirin unless specifically told to do so by their physician. Do not give aspirin to your child
without specific doctor instructions. Remember that Pepto-Bismol contains aspirin as well; so do not give
it to your child!
4. Sponging. Sponging usually is not necessary to reduce fever. Never sponge your child without giving
him acetaminophen or ibuprofen first. We rarely recommend sponging for fever, but if you choose to do so, sponge your child only if the fever stays over 1040 F 30 minutes after your child has taken acetaminophen or ibuprofen. If you do sponge your child, sponge him in lukewarm water (comfortable to your hand). Sponging works much faster than immersion, so sit your child in 2 inches of water and keep wetting the skin surface. If your child shivers, stop sponging or increase the temperature of the water. 5. Treatment for all fevers.
Encourage your child to drink a lot of cold fluids. Have your child comfortably dressed. If he/she is shivering, cover with clothing and/or a blanket only enough to make comfortable. If he/she is hot and sweating, undress enough to make him/her comfortable. For fevers of 100 to 1020 F, cold fluids and dressing them comfortably are the only treatments necessary [medication (acetaminophen, ibuprofen, or both) is not necessary]. CALL YOUR CHILD’S PHYSICIAN IMMEDIATELY IF:
Your child is less than 3 months old and has a temperature of 100.40 F or higher (taken rectally). The fever is very high (1050 F or higher). Your child also has a rash with the fever. CALL YOUR CHILD’S PHYSICIAN WITHIN 24 HOURS IF:
Your child is 3 to 6 months old (unless the fever is due to a DTaP vaccine shot). Your child has had a fever more than 24 hours. The fever went away for over 24 hours and then returned. Dosages of Medications for Treating Fever in Infants & Children

Acetaminophen (Tylenol®, Tempra®, generics)
• Acetaminophen comes in infant drops (80 mg/0.8 ml), children’s suspension (160 mg/5ml), chewable tablets (80 mg/tablet), Meltaways (80 mg), and junior strength chewable tablets (160 mg/tablet) • Shake the drops and suspension well before using and use the dropper or measuring cup provided with the medicine for measuring the dose of medicine for your child. • Find the right dose on the chart below. If possible, use weight to dose; otherwise, use age. • If needed, repeat dose every 4 hours • Do not use more than 5 times in 24 hours Dosage Chart for Acetaminophen
Infant’s
Junior Strength
Weight (lb)
Concentrated
Children’s
Chewable
Chewable
Suspension

Ibuprofen (Children’s Advil®, Children’s Motrin®, and generics)
• Ibuprofen comes in infant drops (50 mg/1.25 ml), children’s suspension (100 mg/5ml), chewable tablets (50 mg/tablet), junior strength chewable tablets (100 mg/tablet), and Junior Strength Swallow tablets (100 mg/tablet). • Not approved for use in infants less than 6 months of age. • Do not give more than directed. Shake the suspensions well before using. • Find the right dose on chart below. If possible, use weight to dose; otherwise use age. • Measure with the dosing device provided with the bottle. • Repeat the dose every 6-8 hours, if needed. Do not use more than 4 times a day. Dosage Chart for Ibuprofen
Infant’s
Junior Strength
Weight (lb)
Concentrated
Children’s
Chewable
Chewable
Suspension

Source: http://umc.ua.edu/files/2010/03/Fever-Management-English.pdf