When Does Fever Spell E-M-E-R-G-E-N-C-Y?

Walk into most emergency departments and you're bound to find at least one fever suffering child in the waiting room. While a high temperature can be serious, understanding fevers can help parents know when a trip to the emergency department is necessary.

"Fever is one of the body's defense mechanisms to fight viral and bacterial infections," explains Dr. Wayne Pasanen, chief of Emergency Medicine at Lowell General Hospital. "Parents should consider a child's age, behavior, eating, and pre-existing health problems when assessing a child's fever," he says.

How Hot is Too Hot?

Dr. Pasanen offers the following checklist for parents:

  • If your child is under three months old and has a temperature over 100.4, speak with your doctor or have your child evaluated by a physician. Infants don't fight infection as well as older children.
  • If your child is three to six months old and has a temperature of 101, do the same.
  • If your child is over six months old, you usually do not need to call your doctor unless your child's temperature is over 103, provided that he or she is otherwise symptom-free.
  • At any temperature, if your child shows signs of excessive sleepiness or lethargy, pain, poor color, stiff neck, or inability to keep down liquids, call your doctor or have your child evaluated in the emergency department immediately.

What Can You Do?

"If your child has no other symptoms, acetaminophen may be the answer," Dr. Pasanen says. "Avoid aspirin, since it's been associated with Reye's syndrome, a rare but severe illness," he adds. Dr. Pasanen advises parents to check with the doctor before giving their child ibuprofen. He also recommends dressing the child lightly and making sure he or she drinks plenty of liquids. Avoid ice water or alcohol when sponging your child. "A cold or ice water bath could actually increase their temperature. Alcohol can be absorbed through the child's skin, leading to significant problems such as unconsciousness, low blood sugar, or intoxication," he says.

"Remember, a fever indicates that your child may be ill or fighting an infection. Discuss your child's fever with your pediatrician or family doctor." Dr. Pasanen adds, "Don't panic, just be prepared."

Lowell General Hospital, 295 Varnum Avenue, Lowell, Massachusetts 01854, Main Telephone: (978) 937-6000
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