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15.02.2014
Children’s fever

lihoradka

 

 

First aid

Literature

 

 

 

 

 

First aid

You can start with non-drug methods for lowering the high temperature. 

Prescribing of an additional amount of fluid necessary to any child with fever to prevent dehydration, easily occurs in children due to rapid breathing and sweating and leading to blood clots.  Additional fluid is given to children older than one year in the form of berry and fruit drink, broths, juices. Dietary restrictions are determined by the nature of illness, premorbid background. Physical cooling methods increase heat transfer from the body surface. Typically it’s used sponge moistened with water or 40-50% alcohol with blowing the body for 5 minutes, every half hour (4-5 times). They aren't advised if the child has signs of microcirculation disorders (fever "white" type). Physical methods of external cooling are especially effective at a neurogenic fever of children. The rate of temperature decrease 1-1,5 º C for 30-60 minutes. The duration of use of fever reducing medicines is not more than 3 days, analgesics - up to 5 days. Children at risk should start with antifebrile drug therapy. Although many drugs have antipyretic action, but only two of the commercially available are optimal for the treatment of children’s fever: paracetamol, ibuprofen.

Antipyretics are prescribed for:

1. Previously healthy children: when the body temperature above 39,0 ° C and / or a muscular ache and / or headache.

2. Children with febrile convulsions in history: when the body temperature above 38,0-38,5 ° C.

3. Children first 3 months of life: at body temperature above 38,0 ° C.

4. In severe heart or lung disease at a temperature above 38.5  C

Early prescribing of antipyretics to children is also shown: inherited abnormalities of metabolism, convulsions in the past, with signs of circulatory failure, II st. and more, with respiratory failure II st. and more, dehydration, prolonged fever; thymomegalia 2st.and more, "white" hyperthermia. 

However arguments against mandatory use antipyretics should be considered for any temperature increase: fever may be the only diagnostic and prognostic indicator of disease, antipyretic therapy " shades " the clinical picture of the disease, providing a sense of false safety; febrile reaction - protective, strengthens the immune response and etc., antipyretic therapy has also a certain risk, including the side effects of drugs. It is impossible to prescribe regular (course) intake of antipyretic medicines. Its repeated doses can be used only after the new increase in temperature to above the specified level. 

Antipyretics aren't prescribed together with antibiotics because it can mask absence of treatment effect and delay the change of the antibiotic (exception - convulsions or heat disorder).

Children are forbidden to use an antipyretic acetylsalicylic acid (Aspirin) in connection with severe toxic effects and the development of Reye syndrome. The use of analgin inside as an antipyretic is also prohibited because of the risk of agranulocytosis and persistent hypothermia. The main antipyretic medicines are paracetamol 10-15 mg / kg daily dose of 60 mg / kg and ibuprofen 5-10 mg / kg daily dose of 20 mg / kg. In such doses, these drugs have the same febrifugal effect. 

 

 

Recommended literature

1. http://www.medlinks.ru/article

2. http://www.medafarm.ru

3. http://www.medlinks.ru/article.php?sid=20777

4. http://pediatric.mif-ua.com/archive/issue-7922/article-7954/

5. http://medafarm.ru/php/content.php?id=3522

6. Acute respiratory infections  in  children: treatment  and prevention. Scientific andpractical program. - M., 2002.

7. Geppe N.A. On  the use of  antipyretics  in children. - j. Clinical Pharmacology and Therapeutics, 2000, 9 (5),  pages 51-53.

8. Tabalin V.A., Osmanov I.M., Dlin V.V. The use of  antipyretics  in  children. - j. Clinical Pharmacology and Therapeutics, 2003, 12 (1).

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