MEDICAL MOMENTS: WHEN IS A FEVER AN EMERGENCY?

12 Oct MEDICAL MOMENTS: WHEN IS A FEVER AN EMERGENCY?

Telluride Inside… and Out is proud to feature the Telluride Medical Center’s MEDICAL MOMENT, a weekly column that answers common medical questions in pop culture. Have a question for the doctors? Click here to send.

Dr. Diana Koelliker answers this week’s question:

Fever by itself is not an illness, but a symptom for a range of medical
conditions. Fever is one of the most common reasons parents visit an
emergency department with a child.

Dr. Diana Koelliker

Elevated body temperature also plays an important role in the body’s normal
response to fighting infection. Most people consider 98.6 degrees
Fahrenheit (F)  a healthy body temperature, but a person’s normal body
temperature may vary a degree or more, and it fluctuates during the day
(lower in the morning, higher at night).

Fever in an adult isn’t usually dangerous unless it registers 103 degrees F
or higher. Seek immediate medical attention if your fever (adult) is
accompanied by any of the following symptoms or conditions:

•Pain or tenderness in the abdomen
•Severe headache
•Stiff neck that resists movement
•Convulsions or seizures
•Difficulty breathing
•Strange behavior, altered speech
•Mental status changes, confusion, difficulty waking, extreme sleepiness
•Rash (particularly if it looks like small bleeding spots under the skin)

If you are undergoing chemotherapy, call your doctor immediately if you
develop a fever above 100.4 degrees F.

Fever can be dehydrating, so drink plenty of fluids.
For children under age one, the best liquid is an oral rehydration
solution, such as Pedialyte.

For children, fever is considered a rectal temperature of above 100.4
degrees F.  Note that other methods of checking a temperature
(axillary/under the arm, tympanic/in the ear, oral) may give a falsely
lower or higher temperature.  A rectal temp is the most accurate.

Although rare, some children under age five can experience seizures,
especially if the child’s temperature rises or falls rapidly. Seizures can
be very alarming to parents, but do not cause permanent harm in most
children.

Call your pediatrician or seek emergency care if your child has a fever of
104 degrees F or higher despite anti-pyretics (acetominophen or ibuprofen).
Until you get help, remove any unnecessary clothing and try to cool the
child down. If at home, you can sponge the child with lukewarm water, place
the child in a tub of lukewarm water or let the child rest under a single
layer of thin towels which have been dipped into cool water and wrung out.
Don’t let the child get chilled. Don’t use alcohol or ice water.

Contact a physician for any child with a fever who:

•Is under three months of age and whose temperature is greater than 100.4
degrees F (38 degrees C), because infants don’t have well-developed immune
systems and could have serious infections
•Has a sustained body temperature higher than 102 degrees F despite giving
medications to treat the fever
•Looks very sick, is unresponsive and uninterested in the surroundings, is
sluggish and won’t suck on breast or bottle
•Cries constantly, continuously or without relief.
•Is difficult to waken
•Has a stiff neck
•Has purple spots on the skin
•Has difficulty breathing
•Is drooling excessively or having great difficulty swallowing
•Has a limp or will not use an arm or leg
•Has significant abdominal pain
•Has painful urination or difficulty urinating.
•Has a seizure (fit or convulsion) for the first time

Most illnesses associated with fever run their course over a period of time
and can be treated with acetaminophen or ibuprofen (unless the person is
allergic or has been advised by a physician not to take these medications).
Acetaminophen or ibuprofen are dosed based on a child’s weight, so ask your
doctor the appropriate dose of those medicines.

Aspirin should not be given to children or teenagers under age 19 because
of the possibility of developing Reye’s Syndrome, a rare but potentially
fatal medical disorder. In addition, ibuprofen is not recommended for
infants younger than six months of age.