THE body temperature can best be determined by the use of thermometer. There are several types of thermometers. These are glass mercury, electronic and ear (tympanic) thermometers.
In developing countries, glass mercury thermometer is still being used. It is inexpensive and if used properly may give an accurate temperature recording.
Rectal temperature is considered the gold standard commonly used in young children.
Oral temperature recordings are mostly used in adults. Armpit temperature recordings maybe less accurate than rectal but are easier and safer to measure. Broken glass particles are the common hazard associated with glass mercury thermometer.
In areas where there is no available thermometer, parents rely on the traditional subjective methods of fever assessment mostly by the use of the palpating hand. With this method, mothers can detect fever in most cases and can even identify those children without fever.
The underlying cause of fever should always be investigated and appropriate treatment instituted. There are some controversies whether to treat fever in children or not. Those who advise treatment stress prevention of convulsion and patient comfort.
Those who are against treatment cite the hazards of potential over dosage of anti-fever medications by worried and anxious parents.
Opponents to treatment further claimed that febrile convulsion most often occur as initial manifestation of fever. You only know that the child has fever because of convulsion. However, most pediatricians agree that children with temperature over 38.50C should be treated with safe and reasonable approach to fever management.
There are certain procedures that may help lower a high fever. Maintenance of adequate hydration and bed rest is important in an effort to keep bodily functions at a minimum.
Remove the child's blanket and heavy clothing and maintain a normal room temperature. To hasten evaporation of perspiration, circulating fans or air conditioning may be used during hot weather.
A safe yet inconvenient method of lowering elevated body temperature is sponging the body with tap water. Evaporation of water results in heat dissipation and lowering of fever may be considered. Paracetamol and Ibuprofen are the common drugs used to reduce fever. Because of its many side effects, the use of aspirin for treating fever in children is no longer recommended.
Studies have shown a possible link between a potentially fatal disorder known as Reye's syndrome and aspirin use in children with fever.
Newborn babies with fever are best treated with tap water sponging rather than by the use of drugs. The potential for accumulated drug toxicity is possible because of the decreased ability of the newborn to metabolize and eliminate the drugs properly.
The use of ice water sponging is highly effective in lowering body temperature but often associated with increased discomfort and shivering. Increase muscular contractions from shivering will increase the body's heat production and contribute to the increase in fever. Alcohol sponge baths are no longer recommended because of the potential for absorption of alcohol through the skin.
There are reports of severe lowering of blood sugar (hypoglycemia) and unconsciousness (coma) from the excessive use of sponging with alcohol.
Antibiotics should not be used to treat fever. Antibiotics maybe used if the cause of fever is due to bacterial infection. As a rule the use of antibiotics should always be under the physician's direct supervision.
Very high fever may cause convulsions. It is usually the suddenness or the rapid rise of temperature that triggers convulsions.
Although frightening for parents, children seldom die during convulsions. This only happens if the airway becomes obstructed, most often by the inhalation of vomitus (the contents of the stomach ejected during vomiting).
If a febrile child is convulsing, do not panic. Under no circumstance should a convulsing child be let alone. Protect the child against self-injury and the aspiration of vomit.
Place the child on his side on bed or on the floor with the neck slightly extended so that secretions drain out of the mouth and not obstruct the airway. Loosen tight clothing around the neck so that the airway is clear.
The less done to the patient during this brief convulsive episode, the better. It is better not to thrust a spoon handle or anything including your finger into the clenched teeth of a convulsing child.
You may lose a finger doing this. Do not try to stop convulsive movements by heavy-handed restraints or by biting the toe or finger since greater trauma is liable to happen. Most febrile convulsions will stop spontaneously. Then bring the child to the hospital for proper evaluation and treatment.
