A child's high temperature is the most common complaint with which mothers turn to a pediatrician. If this situation arises, panic occurs frequently in the family, especially if the child is very small. It is important to know the rules for reducing temperature and learn to understand when emergency medical intervention is necessary.
In the first few days of life, the temperature of the newborn's body can be slightly elevated (37.0-37.4 C in the armpit). By the year it is set within the limits of the norm: 36.0-37.0 degrees C (more often 36.6 degrees C).
Elevated body temperature (fever) is a general defensive reaction of the body in response to a disease or damage. In modern medicine, fever due to infectious diseases and non-infectious causes is distinguished (central nervous system disorders, neuroses, mental disorders, hormonal diseases, burns, injuries, allergic diseases, etc.).
The most common infection is fever. It develops in response to the action of pyrogens (from the Greek pyros - fire, pyretos - heat) - substances that increase body temperature. Pyrogens are divided into exogenous (external) and endogenous (internal). Bacteria, getting into the body, actively multiply and in the course of their vital activity, various toxic substances are released. Some of them, which are external pyrogens (supplied to the body from outside), are capable of raising the temperature of a person's body. Internal pyrogens are synthesized directly by the human body itself (leukocytes - blood cells, liver cells) in response to the introduction of foreign agents (bacteria, etc.).
In the brain, along with the centers of salivation, respiratory, etc. is the center of thermoregulation, "tuned" to the constant temperature of the internal organs. During illness, under the influence of internal and external pyrogens, thermoregulation "switches" to a new, higher temperature level.
High temperature in infectious diseases is a protective reaction of the body. Against this background, interferons, antibodies are synthesized, the ability of leukocytes to absorb and destroy foreign cells is stimulated, and the protective properties of the liver are activated. In most infections, the maximum temperature is set at 39.0-39.5 C. Due to the high temperature, microorganisms reduce their rate of reproduction, lose the ability to cause disease.
How correctly to measure temperature?
It is desirable that the baby has his own thermometer. Before each use, do not forget to wipe it with alcohol or warm water with soap.
To find out what indicators are the norm for your baby, measure his temperature when he is healthy and calm. It is advisable to measure it under the armpit and in the rectum. Do this in the morning, afternoon and evening.
If the baby is sick, measure the temperature three times a day: morning, afternoon and evening. Every day at about the same time throughout the illness, especially important for children at risk. Record the measurement results. On the temperature diary the doctor can judge the course of the disease.
Do not measure the temperature under the blanket (if the newborn is heavily wrapped, its temperature can greatly increase). Do not measure the temperature if the kid is scared, crying, overly excited, let him calm down.
In which areas of the body can I measure the temperature?
The temperature can be measured in the armpit, in the inguinal fold and in the rectum, but not in the mouth. An exception is the measurement of temperature using a dummy thermometer. The rectal temperature (measured in the rectum) is approximately 0.5 degrees C higher than the oral (measured in the mouth) and a degree above the axillary or inguinal. For the same child, this variation can be quite large. For example: the normal temperature in the armpit or inguinal fold is 36.6 degrees C; the normal temperature measured in the mouth is 37.1 degrees Celsius; the normal temperature measured in the rectum is 37.6 degrees C.
The temperature just above the generally accepted norm can be an individual feature of the baby. Evening rates are usually higher than the morning ones by a few hundredth degree. The temperature can rise due to overheating, emotional excitement, increased physical activity.
Measuring temperature in the rectum is convenient only for small children. Five-six-month-old kid deftly twists and will not let you do it. In addition, this method can be unpleasant for the child.
To measure rectal temperature, the most suitable electronic thermometer, which allows you to do it very quickly: the result you get in just one minute.
So, take a thermometer (mercury pre-shake to a mark below 36 degrees C), lubricate its tip with baby cream. Put the baby on the back, lift its legs (as if you were washing it), with the other hand, gently enter the thermometer into the anus approximately 2 cm. Fix the thermometer between two fingers (like a cigarette), and squeeze the baby's little fingers with other fingers.
In the groin and in the armpit, the temperature is measured with a glass mercury thermometer. You will receive the result in 10 minutes.
Shake off the thermometer to below 36.0 degrees C. Dry the skin in wrinkles as moisture cools the mercury. To measure the temperature in the groin, lay the baby on the barrel. If you make measurements under your armpit, put him on your knees or take him in your arms and walk with him around the room. Place the thermometer so that the tip is completely in the skin fold, then with your hand, press the baby's handle (leg) to the body.
What temperature should be lowered?
If your child is sick and he has a fever, be sure to call a doctor who diagnoses, prescribes treatment and explains how to carry it out.
According to the recommendations of the World Health Organization (WHO), initially healthy children should not reduce the temperature, which has not reached 39.0-39.5 degrees C.
The exception is children at risk who previously had seizures in the presence of fever, children of the first two months of life (at this age, all diseases are dangerous for their rapid development and a sharp deterioration in the general condition), children with neurological diseases, chronic diseases of the circulatory system, respiration , with hereditary metabolic diseases. Such babies already at a temperature of 37.1 degrees C should immediately give antipyretic drugs.
In addition, if a child has a worsened condition despite a temperature not reaching 39.0 degrees C, there is a chill, muscle pain, pale skin, then antipyretic drugs should be taken immediately.
In addition, fever exhausts and depletes the body's capabilities and can be complicated by hyperthermia syndrome (a variant of fever, in which there is a violation of the functions of all organs and systems - convulsions, loss of consciousness, respiratory and cardiac disorders, etc.). This condition requires urgent medical intervention.
How to reduce the temperature?
1. The child should be kept cool. To warm a child with a high temperature with the help of blankets, warm clothes, a heater installed in the room is dangerous. These measures can lead to a thermal shock if the temperature rises to a dangerous level. Equip a sick child easily, so that excess heat can flow unhindered and keep the room at a temperature of 20-21 degrees C (if necessary, you can use an air conditioner or a fan without directing the air to the child).
2. As the loss of fluid through the skin increases at high temperatures, the child must be drunk abundantly. Older children should, as often as possible, offer diluted fruit juices and juicy fruits and water. Infants should be more often applied to the chest or give them water. Encourage frequent drinking a little (from a teaspoon), but do not rape the child. If the child refuses to take liquid for several hours a day, inform the doctor about it.
3. Wiping. Used as an adjuvant in conjunction with other measures to reduce temperature or in the absence of antipyretic drugs. Wiping is indicated only for those children who previously had no seizures, especially against the background of increased fever, or no neurological diseases.
To wipe, use warm water, the temperature of which is close to body temperature. Cool or cold water or alcohol (once used for antipyretic wiping) can cause not a drop, but a rise in temperature and trigger a shiver that tells the "confused" body that it is necessary not to reduce, but increase the release of heat. In addition, inhale vapors of alcohol is harmful. The use of hot water also raises body temperature and, like wrapping, can cause heat stroke.
Before starting the procedure, put three cloths in a bowl or a basin of water. Put on the bed or on your knees an oilcloth, on top of it a terry towel, and on it - a child. Undress the baby and cover it with a sheet or diaper. Squeeze one of the rags so that water does not drip from it, fold it and put it on the forehead. When drying cloth, it should be wet again.
Take the second cloth and begin to gently wipe the child's skin moving from the periphery to the center. Pay special attention to the feet, legs, popliteal folds, inguinal folds, brushes, elbows, underarms, neck, face. Blood that has tasted to the surface of the skin with light friction, will be cooled by evaporation of water from the surface of the body. Continue to wipe the child, changing the cloths as necessary for at least twenty to thirty minutes (to lower body temperature it takes just that much time). If in the process of wiping the water in the basin cools, add a little warm water to it.
4. You can pre-freeze water in small bubbles and, having wrapped them with a diaper, apply to areas where there are large vessels: inguinal, axillary areas.
5. Use of antipyretics.
Drugs of choice for fever in children are PARACETAMOL and IBUPROFEN (trade names for these medications can be very diverse). IBUPROPHEN is recommended to be prescribed in cases when paracetamol is contraindicated or ineffective. A longer and more pronounced decrease in temperature after application of IBUPROPHEN was noted than after PARACETAMOL.
AMIDOPYRIN, ANTIPIRIN, FENACETHINE are excluded from the list of antipyretic agents because of their toxicity.
Acetylsalicylic acid (ASPIRIN) is prohibited for use in children under 15 years of age.
Widespread use of METAMIZOL (ANALGINA) as an antipyretic is not recommended by WHO, because he oppresses hematopoiesis, is capable of causing serious allergic reactions (anaphylactic shock). Possible long-term loss of consciousness with a decrease in temperature to 35.0-34.5 degrees C. Metamizol (Analgina) administration is possible only in cases of intolerance to drugs of choice or, if necessary, intramuscular injection, which should only be performed by a doctor.
When choosing the form of the medicine (liquid medicine, syrup, chewing tablets, candles), it should be taken into account that the preparations in solution or syrup act after 20-30 minutes, in candles - after 30-45 minutes, but their effect is longer. Candles can be used in a situation where the child has vomiting when taking a liquid or refuses to drink a medicine. Candles are best used after defecation of the child, they are conveniently administered at night.
For medicines in the form of sweet syrups or chewable tablets, allergies may occur because of flavorings and other additives. The active substances themselves can also cause an allergic reaction, so that with the first techniques you need to be especially careful.
If you give medicines to a child, especially those related to the dosage at certain ages, you should carefully study the instructions so as not to exceed the recommended dose. It should be borne in mind that a doctor can change the dosage for your child.
If you alternately use different forms of the same medicine (candles, syrups, chewable tablets), you must sum up all the doses received by the child in order to avoid an overdose. Repeated use of the drug is possible not earlier than 4-5 hours after the first intake and only in case of temperature increase to high rates.
The effectiveness of a febrifuge is individual and depends on the specific child.
What not to do if the child has a fever
- Do not make the baby lie. A really sick child himself will be in his crib. If your baby wants to get out of it, you can completely allow him to do something quiet. Try to avoid excessive activity: this can lead to an increase in temperature.
- Do not put the child in an enema unless the doctor specifically prescribed it.
- Do not wear or cover your child too warmly.
- Do not cover the baby with a wet towel or a wet sheet: this can prevent the heat from being released through the skin.
When is it necessary to call the doctor again to the baby?
- Measured, the temperature in the armpit is 39.0-39.5 degrees C, the rectal temperature has exceeded 40.0 degrees Celsius.
- The child had convulsions for the first time (body is tense, eyes roll, limbs twitch).
- The child inconsolably cries, screams from pain when touched or moved, moans, does not react to external stimuli, or his body softens.
- The baby had purple spots on his skin.
- The child is difficult to breathe even after you have cleared his nasal passages.
- The neck of the child seems tense, and he does not allow him to bend his chin to his chest.
- The heat begins after staying at an external heat source: for example, in the sun on a hot day or in the car in hot weather. Possible heat stroke, which requires immediate medical attention.
- Sudden rise in temperature occurred in a child with slightly elevated temperature, but too warmly dressed or wrapped in blankets. It should be treated like a heat stroke.
- The doctor told you to immediately report if the child starts fever.
- It seems to you that the child has something serious, although you are at a loss to say why they decided so.
- The child has worsened chronic diseases (heart disease, kidney disease, neurological disease, etc.).
- The child is dehydrated, as can be seen from such signs as: a rare urination, a dark yellow color of urine, a small amount of saliva, tears, sunken eyes.
- The behavior of the child seems atypical: it is unusually capricious, apathetic or overly sleepy, can not fall asleep, is sensitive to light, cries more than usual, refuses to eat, pulls itself by the ears.
- The child had a low temperature for a few days, and then suddenly rose sharply, or a child with a cold, which arose a few days ago, suddenly had a fever. This heat may indicate a secondary infection, for example, otitis media or strep throat.
- The fever does not decrease with taking medication.
- The temperature of 37.0-38.0 degrees C persists for a long time (more than a week).
- The fever lasts for more than a day without any other signs of illness.
In all these cases, you should contact your doctor even in the middle of the night or go to the emergency room.