FAQ's on FEVER
What is fever ?
 Fever is
defined in medical terms as a body temperature of more than 37 degrees
Celsius. We often are more familiar with using the Fahrenheit Scale – in
which any temperature over 98.6 is defined as fever.
Medical word for fever :
The technical term
for fever is Pyrexia.
Why
does a person have fever ?
Fever is the body’s natural defense mechanism and
is better understood as an external appearance of the internal fight going
on between the infectious agent
( any germ , virus or bacteria that are causing an infection ) and the
body’s immune system. From this brief background it is easy to follow that
fever is usually the first external manifestation of the internal
disturbance. It is fever that brings the person to the doctor and we thus
call it a parent’s friend than a foe ! Were is not for fever – perhaps the
internal disturbance would go on unchecked till point of no control before
one sought medical advice.
When is fever significant ?
Though any
rise in body temperature is counted as fever and should be a cause for
concern – there are some situations when the “ fever “ may be a “ normal
phenomenon” : for example in extremely hot seasons newborns may develop a
short lasting “ fever “ that may not be of concern as long as the newborn is
doing well otherwise. This is known as “ Environmental Pyrexia” and needs
only to reduce the room temperature and to reduce the child’s clothing and
then monitor the temperature again after some ½ - 1 hour – if raised
temperature persists then you certainly need to consult your Pediatrician
soon as possible.
Is
infection the only cause of fever ?
Though
infections are the overwhelmingly leading cause of fever – some other
diseases or other problems may also cause fever. These may lie beyond the
common understanding of lay people and are best addressed by your
Pediatrician than your jumping to conclusions.
High Thyroid state ( Hyperthyroidism) , other hormonal
disturbances such as may occur at menopause , poor sweating capacity ( a
specific disease ) and other esoteric and remote causes also exist .
Interestingly , drugs ( any drug for that matter ) may cause fever and is
known medically as Drug Induced Pyrexia. Elimination of all drugs and then
watching the fever pattern is a step often taken by Doctors in such
situations.
Anyhow – for all practical purposes , a lay person may well presume that all
fevers ARE caused by infections and seek advice soon as possible.
How should I measure temperature :
Temperature
is best measured by the conventional method of taking the underarm
temperature or
the mouth temperature. The more scientific method ( and of
special use in newborns ) is
measurement of rectal temperature. This more
accurate method has its serious handicap of being dangerous in untrained
hands. Some newly devised instruments measure the temperature inside the
ear
( known as Aural Temperature ) - it is a very good and child friendly method
though the instrument is not easily available in India.
The commonly available Thermometers are known as Clinical Thermometers ( as
against those used for measuring room temperatures and those used in
chemical and physical laboratories ). Two commonly available instruments are
the cheaper Mercury Thermometer and the costlier Digital one. The mercury
one is fairly reliable though it has the hazard of mercury spillage in the
mouth if the child bites the tip – hence we usually recommend underarm
recording.
Shake your mercury thermometer properly so that the silvery looking fine
line of mercury falls well below the arrow mark ( usually set at 98.6
degrees F , or 37 degrees Celsius ) and then keep the mercury tip in the
underarm for the time specified on the instrument ( usually 1 minute ) .
Take the reading after that time and ADD 1 degree for correction – this
added value gives you the correct body temperature reading. If used in the
mouth – keep the mercury tip under the tongue for the specified time and DO
NOT ADD any further value – mouth reading is to be recorded as such.
Any instrument is prone to inaccuracies and clinical experience abounds with
stories of hectic investigation and unnecessary treatment for instrumental
error giving “Fever”. It helps to try out a newly purchased instrument on
yourself and some other members of the family who you feel do not have
fever.
The Digital ones are very easy to use and usually give an audible alarm when
the reading is complete. Their higher cost is fairly justified by the
convenience and risk free usage they offer . The precaution of taking any
electronic instrument with a pinch of salt has always to be kept in mind –
do calibrate it the way we recommend for the ordinary mercury device.
What is
the first aid I should give for fever ?
Paracetamol (
known in the Western world as Acetaminophen ) is by far the best medicine
for fever and usually will take care of any type or degree of fever.
The commonly available brands in the Indian market are : Crocin , Calpol ,
Metacin ( available as 500 mg tablets , syrups containing 125 mg per 5 ml
and drops containing 125 mg per ml where 1 ml has some 16 drops to it ).
As a thumb rule a child needs some 10 mg per kilogram of bodyweight as a
dose and one can give it as frequently as every 4 hourly if needed. The
syrup works out to a ready calculation of one 5 ml measure per 10 kilogram
body weight and the drops work out to double the number of drops as the body
weight in kilograms.
The other commonly available and used preparations are Ibuprofen ( Brands :
Brufen , Ibugesic ) ; Ibuprofen and Paracetamol combinations ( common brands
: Combiflam , Ibugesic Plus ) ; Nimesulide ( common brands : Nimulid , Nise
) and a host of other formulations and combinations.
What else can I do for reducing fever apart
from medicines ?
Sponging of
the body is a commonly known method of reducing temperature but there are
several myths and fallacies relating to the correct technique. For your
understanding – sponging with water causes reduction in body temperature by
heat loss through evaporation of water on a hot body surface.
1
The water should NOT be cold ( as is commonly understood by Cold
Water Sponging ) – it should instead be lukewarm / tepid. Cold water causes
shrinkage ( constriction ) of the blood capillaries under the skin and
causes poor blood flow to the skin – resulting in poor heat flow to the
surface of the body and poor effect of sponging.
2
The whole body needs to be sponged and NOT just the forehead and
exposed limbs as is commonly practised. The larger the surface area sponged
the better the results. Thus you need to expose the whole body by making the
child naked and wipe the whole body with a tepid / lukewarm cloth and then
leave the body exposed naked for a while and the clothe the child. Clothing
soon after sponging causes paradoxical rise in temperature by trapping body
heat in the cloth – body surface interface.
3
Sponge as frequently as needed – you may need some 3-4 spongings for
good effect.
How
often do I need to measure fever ?
It depends on
the need of the parent and the need of the Doctor.
As a parent you may need to measure whenever you feel the child has fever.
Your Doctor may , at the
same time ask you to measure fever on a fixed schedule for a certain number
of days. What
he is looking for is a specific pattern ( i.e. is the fever more in the
evenings , does the fever
have a once a day spike , does the fever
continue throughout the day and so on ) – he shall draw his
conclusions based on this
pattern on fever.
As a general rule – and
specifically so for prolonged fevers – a thrice daily schedule is optimum –
morning , late afternoon and night. You may do well to maintain a chart such
as below and also keep a column for any observations you make with the fever
pattern – such as chills.
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Date
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Morning ( time)
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Late Afternoon
( time) |
Night (
time) |
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