One of the most common questions that I get asked in my clinical practice is “what is a fever” and “when should I take my child to an emergency room with a fever”.
Firstly a fever is any elevation of body temperature above the set point (around 37.3 C). The most accurate recording of a temperature would be a rectal temperature but at home peripheral recordings such as ear, underarm or forehead are more than sufficient. Fevers can result from many different causes but most commonly they are caused by infections in children. Most childhood infections are viral, but children can also get bacterial and parasitic infections too.
Not all fevers need to be treated, but if your child is very uncomfortable, vomiting from an elevated temperature or in pain I would suggest treating them. To treat a fever we use non-medical and medical means. Non-medical interventions include drinking cool fluids, taking some layers of clothing off or tepid sponging; medical interventions include either the use of paracetamol or a non-steroidal anti-inflammatory in either the syrup or suppository form.
There is no specific temperature value that would necessitate rushing a child into the emergency room. There are however warning signs and symptoms that if associated with a temperature in a child require urgent medical attention. These would include:
- Any child less than 3 months old or any temperature that is not coming down despite medical (at the correct dose!) and non-medical interventions
- A younger child: Irritability or lethargy, not willing to drink, a severe purple/red non blanching rash, signs or concerns of dehydration due to poor drinking or excessive vomiting
- An older child: A severe head ache and neck stiffness, confusion and disorientation, a widespread non blanching purple/red rash, dehydration
All other temperatures can be managed at home and medical advice can be sought during office hours.
Article by: Dr Megan Page
De Megan Page is based in Claremont Cape Town her practice provides comprehensive primary level paediatric care for patients between the ages of 0 and 16 years and neurodevelopmental screening assessments. Based in Claremont, both Megan and Juliet have great working relationships with many of the paediatricians and relevant specialists in the area.