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FEVER
A rise in body temperature
(pyrexia) is one of the effects and symptoms of
many illnesses, particularly of infections, and
is related to the process by which the body
copes with the invading disease-causing
organisms. Taking the temperature is therefore
one of the objective ways of testing whether a
child is ill, and the thermometer is a useful
item to have in the family medicine chest.
Taking a child’s
temperature
A thermometer consists of a
glass tube marked in degrees, either in
Fahrenheit (F) or Centigrade (C) or both. It
contains mercury, a silver liquid, which expands
or heating and the height of the column of
mercury gives a measure of the body temperature.
Before use make sure that the mercury column has
returned to below the arrow marking the normal
temperature (it does not matter how far below)
by shaking it fairly vigorously.
A
thermometer is very easy to read. Turn it so
that you can read the numbers, then turn it
again very slowly until the column of mercury
becomes abroad and shiny. Degrees of temperature
are divided into parts of a degree so that a
more exact reading can be made. The temperature
can be taken in a number of places:
The Mouth: The bulb of
the thermometer should be placed under the
tongue or, slightly less efficiently, between
the cheek and gums, and the mouth closed for two
minutes. This will be difficult for many young
children, especially if their nose is blocked
from a cold. Care must be taken that the
thermometer is not bitten but, God forbid, if
this does happen, do not worry! Give the child
some bread to eat, to act as
‘wrapping’ for the glass. The amount
of mercury absorbed will be insufficient to
cause any serious problems.
Under the arm : Put the bulb of the
thermometer right into the armpit (axilla) and
hold the arm tightly into the chest wall.
Although this is the easiest method, it does not
always give an accurate reading as frequently
the bulb of the thermometer is not completely
covered.
Rectally: This is a reliable method
which usually gives a reading one degree higher
than by mouth. IT is a very convenient method
for children up to two or three years old. A
suitable position is to have the child curled up
on his bed or lying over your lap. Use a little
Vaseline as lubrication on the bulb of the
thermometer and insert it about one inch (2.5
cm) into the rectum, steadying it by holding the
cheeks of the buttocks together.
The significance of the
various temperature levels is:
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NORMAL
TEMPERATURE |
97.50 F to 98.80
F |
36.40 C to
37.10C |
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MILD FEVER
|
99.00 F to 102.00 F |
37.20 C to 38.90
C |
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MARKED FEVER
|
102.00 F to 103.50
F |
38.90 C to
39.70C |
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HIGH FEVER
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Above 103.50
F |
Above
39.70C |
The temperature frequently
varies during different times of the day,
usually being higher at night.
The temperature is only one
indication of a child’s state of
health and account needs to be taken of the
overall picture. Thus normal children may get
very hot at times, especially when they have
been overactive or following excessive crying,
whereas young babies may be very ill even with a
temperature that is below normal. Thus use the
thermometer as part of your assessment of the
child and if you are worried about his general
state of health do not let a normal reading
prevent you from seeking medical advice.
A
young child has only a rather poorly developed
temperature –control mechanism and
therefore the temperature will frequently go up
and down and may reach quite high levels without
the cause necessarily being very serious.
The chief method by which a child
regulates its temperature is by direct heat loss
from its skin, and it is most important
therefore that this is not restricted by the use
of excessive clothing. It is widely held belief
that that an ill child should be kept warm,
quite irrespective of what his temperature might
be – one of the few instances when
parents’ common sense lets them down. If a
child is shivering, it is the result of the body
raising its internal temperature; the rapid
muscular activity releases stored energy in the
form of heat. An important part of an ill
child’s management consists of keeping the
temperature under control.
Complications of a
high fever
Dehydration: A
persistent high temperature will make the body
lose a lot of fluid through increased sweating
and, if this is not replaced , it can result in
impaired kidney function and upset of the body
chemistry.
Fits (convulsions) A
very high temperature (usually, but not always,
over 103.50 F, 39.70 C) may cause epileptic
– like fits (convulsions) in certain
susceptible children usually between the ages of
one and three, and hardly ever after the age of
five.
Management of fever
The cause of the temperature should be
identified wherever possible so that any
appropriate specific treatment can be
undertaken. Frequently the fever is the only
symptom and management consists solely of
keeping the child as comfortable as possible and
controlling the fever until full recovery is
achieved.
Clothing: All excess clothing should
be removed, leaving just loose-fitting light
garments or pajamas. Take care to avoid the
child being in a draught.
Fluids: High fever can cause marked
dehydration and extra fluids need to be given.
Diet:
‘Feed a cold and starve a fever’ is
a useful maxim, as a feverish child usually has
little appetite. When this returns, start with a
small quantity of easily digestible and tasty
foods.
Medication :
Aspirin and paracetamol are very useful means of
lowering temperature and may be given every
three hours in the appropriate close (see
‘Family Medicine Chest’). If there
is a danger of fits, your doctor may prescribe
an anticonvulsant as a preventative.
Tepid sponging: If the
temperature reaches very high levels (i.e. over
103.50F to 104.00F, 39.70 to 40.00C), sponging can
be helpful. All clothes should be removed and
the child liberally sponged all over with tepid
(not cold) water. The water should not be
immediately dried off but allowed to evaporate
as it is this which has the main cooling effect.
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WHEN TO CONSULT THE DOCTOR
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If the temperature
rises over 102.00F (38.80C).
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If there is a
persistent temperature for two to three days.
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If there is a known
tendency for fits to occur with fever.
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If you are worried
about the child .
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