Fever is by far the most common symptom for visit to a Pediatrician. However, we are faced with one of the most challenging days of our time with covid-19. The current situation demands that we must not go anywhere out of our homes, unless it is necessary. Visiting a hospital with our children is even more scary. At the same time we cannot ignore other illnesses our children might suffer. This mandates that we must be cognizant of knowing when we can treat our children at home (with or without over the counter drugs) and when visiting a doctor is worthwhile.
Many of children with fever can be safely managed at home (Yes I do say it!), although fever is very distressing to the parents. In this article I shall highlight when we can treat a child with fever at home and when visit to a doctor is warranted. Also, I shall enlist the situations demanding emergency department visit. However I must say that if the parents do feel that the child really needs to be shown to a doctor, always do visit. We are always happy to see our patients.
Fever is defined as oral temperature more than 100 °F or 38 °C (yes more than this temperature only !). Armpit temperature is normally 1 °F or 0.5 ° C lower than oral temperature.
Yes it can be managed at home! Although for many parents fever in their child is one of the most distressing symptom, it simply shows that the body is fighting against infection. It is a symptom, not a disease. Although it can lead to lethargy in children, fever alone does not cause any harm to your child, unless temperature becomes > 105 ° F (or corresponding 40 ° C), which is fortunately very rare.
Fever (with or without cough and cold), can be managed at home at least for the first 2 to 3 days with paracetamol. Adequate drinking of water is needed. If you have thermometer at home monitor child’s armpit or oral (better) 6th hourly. I would also point out that most counter cough medicines are not recommended in children less than 12 years (as per many Pediatric associations). Most of them cause more harm than good. Although honey or honey based cough syrups can be given in more than 1 year old children. However honey can be harmful in less than 1 year old and must be avoided in this age group.
1. Less than 6 month old child
2. Fever > 101 °F (armpit) or 102 °F oral. More than this temperature (Yes more than this temperature only) is defined as high degree fever. If you have Celsius/centigrade thermometer, the corresponding temperatures are 37.5 °C axillary and 38 °F oral.
3. Fever > 3 days
4. Fever with widespread rash
5. If the child is feeding very poorly in last few days
6. If the child is passing urine very less
7. Pain during urination
8. Vomiting/repeated diarrhea or pain in abdomen/stomach upset
9. Ear pain/ water or pus discharge from ear
10. Pain on one or more joints
11. Bleeding from anywhere
12. If the child is having any long term disease (liver, kidney, lung, heart etc)
13. If the child is on drugs which suppress immunity. Like steroids
1. If the child is behaving abnormally or sleeping most of the time
2. Fits (or anything which you suspect is a fit)
(for first aid for fits, read this article)
4. Passing urine very less or not passing at all for six hours
5. Bleeding which does not stop
In most Indian states the phone number for emergency ambulance service is 108 or 11
Following are the links to touch and infrared thermometers to monitor fever at home