Are you doing the right treatment for children with fever?
Morning nurse tour of the ward When I was in the hospital, I asked the family members of the child with “sepsis” (body temperature at admission was 38.9°C), “How was the child last night, did he have a fever again?”
Family: I have a fever this morning, oh, it’s a low fever.
Nurse: The temperature is How many?
Family: body temperature 37.2 °C.
The child has a fever, yes A major problem that plagues parents, there are still many parents who do not know the law of fever in their children and do not know how to deal with it. It is necessary to introduce it here.
01
What is fever?
Fever: also called hyperthermia High temperature is a clinical symptom that the body temperature is higher than normal due to the pyrogen acting on the thermoregulatory center or the dysfunction of the thermoregulatory center, which increases heat production and reduces heat dissipation.
02
The process and performance of fever
1. Rising body temperature
chills
Clinical manifestations often include fatigue, muscle aches, pale skin, chills or chills, and dry skin.
Body temperature increases in two ways:
(1) Sudden rise type: body temperature reaches 39~40℃ or above within a few hours, often accompanied by chills;
(2) Slow-rising type: The body temperature gradually rises and reaches a peak within a few days, usually without chills ( keep warm).
2. High heat period
Appears as skin flushing, burning, dry lips, skin, deep and rapid breathing, rapid heart rate, headache, dizziness, appetite Weakness, general malaise, weakness, etc.
Features:Heat production and heat dissipation at a high level tend to balance. After the body temperature rises to a peak, it remains for a certain period of time, and the duration may vary due to different etiologies.
3. Hypothermia period
Appears as wet skin and profuse sweating. Due to profuse sweating, a large amount of body fluids are lost, and blood pressure is prone to collapse, collapse or shock.
Features: Heat dissipation is greater than heat production, and body temperature returns to normal Due to the elimination of the cause, the effect of the pyrogen gradually weakens or disappears, the body temperature setting point of the body temperature center gradually drops to the normal level, and the body temperature drops to the normal level.
03
The degree of fever in children
Low fever 37.5~38℃ Moderate fever 38.1~39℃ High fever 39.1~41℃ Ultra high fever 41℃ and above.
04
What should I do if I have a fever?
1. Rest and living care
Fever children should rest in bed to reduce oxygen consumption , relieve headache, muscle soreness and other symptoms. The ward is kept quiet and the environment is suitable, the room temperature is 18~20℃, and the humidity is 50%~60%.
2. Diet and Hydration
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A liquid or semi-liquid diet that provides sufficient calories, protein and vitamins to supplement nutrient consumption. Encourage patients to drink more water, 1-2L/min.
3. Keep it clean and comfortable
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(2) Strengthen skin care: the clothing should not be too thick, so as not to affect the body heat dissipation, During the antipyretic period, if you sweat a lot, you should dry the sweat at any time, change the sheets and clothes, prevent catching a cold, and keep the skin clean and dry.
4. Monitor body temperature
Re-measure body temperature after 1 hour of antipyretic treatment. If prostration is present, keep warm, drink hot water, and in severe cases, give intravenous fluids.
Drug cooling was given when the body temperature exceeded 38.5°C. If infants and young children have fever or even high fever, but they are in good spirits and play as usual, they may not be treated for the time being under close observation. If there is a history of febrile seizures, treatment should be given as soon as possible.
5. Safe Care
Children with high fever sometimes have restlessness and delirium. Falling and falling off the bed should be prevented. If necessary, a bed stop should be added or a restraint belt should be used.
6. Psychological care
In the period of rising body temperature, the child will have chills, pale complexion, nervousness, anxiety and other psychological reactions, and the child should be cared for frequently; Satisfy the psychological comfort of children and pay attention to cleanliness.
05
Can I use antipyretics if I have a fever?
1. No medication if the cause is unknown
Antipyretics should not be used indiscriminately for fever of unknown etiology, especially at the beginning of the fever. Do not use it indiscriminately, so as not to interfere with the original law of fever due to medication.
2. Antipyretics are very common, but side effects are also very common.
Such as drug eruption, gastrointestinal reaction, blood system reaction and damage to liver and kidney function etc., especially when such drugs are used for a long time or excessively, the toxic and side effects are more significant. Therefore, antipyretics must be used with caution.
06
So what should I do if there is a chill?
1. Closely monitor vital signs , and focus on the changes in body temperature. After physical or drug cooling was performed, the cooling effect was evaluated and any discomfort such as collapse was observed during the cooling process.
2. To take effective cooling measures, physical cooling methods are usually used, such as ice caps, ice packs Cold compresses, etc.; patients with high fever accompanied by chills and cold limbs should keep warm, and bathe with warm water after the limbs are hot.
3. Pay attention when cooling down:
(1) Cold compresses should not be placed on the same part for a long time, and the longest should not exceed 30 minutes to prevent frostbite.
(2) Pay attention to observe the surrounding circulation, there is a thin pulse, pale complexion, limbs When it is cold, do not use cold compresses.
(3) It is forbidden to wipe the chest area, abdomen, back neck, The sole of the foot; it is contraindicated for children with generalized rash or bleeding tendency to take a bath to cool down.
4. When the child has high fever and chills (T>38℃), follow the doctor’s advice Blood culture should be drawn as soon as possible, and the child should be kept warm.
5. Psychological care. During the duration of high fever, the physical and mental discomfort caused by high fever should be relieved as much as possible to meet the reasonable needs of children.
07
What if I have a twitch?
1. If the child has a febrile convulsion, call for help immediately, immediately lay the child on his back, turn his head to one side, and loosen his clothes.
2. Place the tongue depressor on the molars to prevent tongue bite.
3. Clean up respiratory secretions in time to keep the airway open and avoid suffocation.
4. Do not force the child to change the position to prevent the child from being injured.
5. Assist medical staff to apply antispasmodic or antipyretic drugs, and quickly give physical cooling .
About the author
Article author: Xing YanQing Xu Caifeng
Author: Liaocheng Second People’s Hospital