What you need to know about fevers
Published Wednesday, December 19, 2012 12:11PM EST
Last Updated Wednesday, December 19, 2012 12:59PM EST
If you're a parent, this has probably happened to you. It's the middle of the night, your child's fever suddenly spikes. What do you do? Emergency physicians at CHEO say most parents suffer from “fever phobia” and so, they see many children within the first few hours of their illness.
“In certain circumstances, it's important to see the children early on in their illness,” says Dr. Sarah Reid, Emergency Physician at CHEO. “For instance, children under 3 months, we need to see those babies as soon as fever presents. But Dr. Reid says in older children who have been immunized and who look well, there is no reason to rush in to the Emergency Department with a fever.
“It's important to know you can treat that fever at home,” says Dr. Reid. “Keep your child comfortable, make sure they're drinking well and when the fever is down and your child is interacting well, that's a very reassuring sign.”
Dr. Reid adds, “I think parents feel fever is a sign of something serious, like serious signs of infections such as meningitis and they come to the Emergency Department looking for that reassurance that nothing serious is going on.”
Tina Tam’s baby is just 33 days old and is sick with a fever. “She's so young, so very easy to pick up germs,” says Tam. “So, that's what we're thinking, she probably has a cold.”
Dr. Reid says Tam and her husband Steven made the right call bringing the infant in to the emergency department to be assessed. Baby Mikalya was checked for a rash, her breathing and heart rate were assessed and ultimately, she was sent for a lumbar puncture to rule out meningitis.
Five-year-old Julienne Hu is in another room in the emergency department. She has had a fever for 10 days and her parents, understandably, are worried.
“The main issue is fever and the first 5 days it was really high,” says father Lei Hu.
“The height of the temperature doesn't necessarily matter,” says ER physician Dr. Anna Karwowska. “It's more how the child looks. If at any point the child looks unwell despite the use of anti-fever medicine, they need to be seen but if they look better, it’s not an issue waiting to see whether any other illness declares itself.”
Because Julienne’s fever has persisted more than 2 or 3 days, Dr. Karwowska says her parents were right bringing her to the Emergency Department. Dr. Karwowska says they are happy to see the children who come to CHEO with fever but there may be nothing they can do. “We may not be able to give them any useful information because fever often identifies as an infection that a child is starting to fight. There may be few symptoms other than fever.” In fact, doctors say 95% of fevers in healthy, immunized children are viruses that go away on their own and don’t require antibiotics.
Your child has a fever if the temperature is greater than:
38.5°C or 101.3°F rectally.
To take a rectal temperature, place the tip of the lubricated thermometer 1-2 cm (½ to ¾ inch) in rectum.
38.0°C or 100.4°F by mouth.
Take a temperature by mouth only if your child is older than 3 years and can keep the thermometer under his or her tongue.
- 37.5°C or 99.5°F underarm.
- A LOW GRADE FEVER is a rectal reading between 38°C (100.4°F) and 39°C (102°F). This is the normal body reaction to fighting infection.
- A MODERATE GRADE FEVER is a rectal reading between 39°C (102°F) and 40°C (104°F). If their temperature is in this range, you should give your child medication to bring the temperature down to low grade.
- A HIGH FEVER is a rectal reading over 41°C (106°F). At this point, you should give your child medication to bring down the fever and see your doctor. Fevers are only harmful if they are above 42.3°C (108°F)
- Children under 2 months with a rectal temperature over 38°C (100.4°F) should see a doctor