Fever is the most common pediatric symptom I encounter in my clinics. There are a lot of myths surrounding it so I’ll be discussing those in a separate FAQ. For now, I am planning to impart to you the correct approach in handling a fever at home.
Taking the temperature
There is a lot of difficulty regarding how high a fever is simply by touching a patient’s forehead. I have met 2 and 3 year-old patients with seizures at the ER. Touching (or palpating) their foreheads and body gave only subtle warmth to my hands. But their temperatures where very high, 40-41°C or 104-105.8°F! If I couldn’t estimate my own’s patients’ temperature using my hand, I don’t think mothers at home can do better without a thermometer.
Don’t rely on intuition or guessing, buy a thermometer.
There are a lot of good thermometers out there that can help you. To my patients, I don’t tell them to buy a specific brand. Eighty percent of my patients couldn’t afford even branded medications so I tell them to buy cheap. I need them to have at least a basic thermometer at home.
What is the BEST thermometer I can buy?
If you ask for the best, I’d recommend an item from my wishlist. I don’t have this yet as this is valued like gold. ExacTemp technology that comes with this gadget is already standard in modern thermometers. Just point inside the ear and click. The only problem I’ll have with this is that the reading faces away from the handle which adds a few seconds to view it. This comes with an anti-theft feature which I would love to have.
What is the cheapest thermometer I could use?
Mercury thermometers are being phased out by most hospitals but they remain THE standard against which digital thermometers are compared. Digital thermometers can be bought for under a dollar (or below Php 50.00)! So I tell my patients that there is no excuse for not having a thermometer at home. It is life-saving. These thermometers are used orally, rectally or under the armpit. They require longer periods of measuring the temperature and varies by up to 0.8°C or 1.6°F compared to aural (ear) temperatures. However, since this will be for personal or family use only, this could be the answer for you.
What thermometer do you use?
I bought mine second hand and I have loved it ever since. I rely on it in my clinics and the temperature readout is awesomely placed on the side of the thermometer. Since most of my nurses and midwives are right-handed, they document fevers faster. The efficiency is reduced though if you’re left handed. Since I have plenty of patients, i need to get exams done fast. So this, thermometer is perfect for me.
The correct definition of fever in terms of temperature
To many geeks or smart aleck persons out there, I hate to disappoint you but it’s a range. According to Harrison’s Principles of Medicine 18th Edition, the definition of fever is
“an a.m. temperature of >37.2°C (>98.9°F) or a p.m. temperature of >37.7°C (>99.9°F)”
Sorry kids, but the old 37.5°C (99.5°F) has been rendered defunct in light of some studies. However due to differences in practice and treatment guidelines, fever at this range is not yet treated. I only tell my patients to take certain medications on certain temperatures.
Best remedy before taking any medications
On my book, Filipino Medical Myths You Should Know, Filipinos are hesitant when it comes to water in fever. I discussed this in Walang Pasma! A tepid sponge bath is always indicated when it comes to fever. As the fever rises, the need for a cooler agent becomes urgent. Yes, we sometimes resort to ice baths in the ER to rapidly cool a patient.
Little Fevers Cooling Cloths for Infants & Children
Pediatric patients can be given Cooling Cloths which works the same way as a tepid sponge bath without the discomfort of bathing. These are available without a prescription and contain herbs that are known to cool skin and increase evaporation.
The decision to treat a fever is best met on clinical grounds by your family doctor. This is the reason for consult. A blood, and urine workup is usually necessary after a thorough physical examination as to the cause of the fever. Antipyretic (anti-fever) medication is not automatic and most doctors prefer to observe rather than treat. The use of antipyretics is largely a quality of life issue and addresses only the comfort of the patient. Fever is a natural response to any infection and is actually an indicator that your immune system is working fine.
However, antipyretics are not contraindicated in fever as studies show it does not interfere with the immune response.
Three drugs are available without a prescription. The best remain to be Ibuprofen, followed by Paracetamol (Acetaminophen), and then Aspirin. Aspirin is contraindicated in pediatric patients. Other drugs do exist but are given with prescription and under the discretion of your doctor. You may take this drugs at home however, you must still seek professional advice after doing so. Your fever may be the first sign of an underlying serious illness.
Disclaimer: The writer is not affiliated with any of the brands mentioned or previewed in this article. The author carefully selected current best evidence for the topic and is valid as of the time of this writing. The reader should be informed that changes in medicine may not be reflected immediately in this article. It is the responsibility of the reader to report and seek professional advice before taking these medications and also to do the same if untoward or adverse effects develop.
Best OTC drugs you can buy over the internet
Always seek consult with your doctor. Fever, however trivial, may be a sign of an important illness. Some think it is prudent to wait it out a few days and yet even some (including a good proportion of my patients) try their luck to wait it out for more than 10 days. It may not be worth the risk. The earlier, the better. We want to insert our management at the earliest possible time so we can prevent complications from happening.