Its happening a lot this time of year. Parents rush their kids into the Emergency Department- for fever. When I get to the bedside, mom is sick with worry. The child, however, is walking about the room, opening cabinets, tugging on the bed controls. It seems the only problem the kid is having is not being able to release the bed brakes so he can race the stretcher up and down the hall.
Its a cough and fever time of year. The Emergency Departments and pediatric practices are full of sick kids. Kids have been coughing on each other in school or day care for three months now, and the influenza virus has joined the mix. Besides the amount of ill kids, the University Medical Center closed its Pediatric Department earlier this year due to state budget cuts, and thus there is one less place to bring children. So what should you do with your child with a fever? Keep them home!
Fever is not an emergency. Fever is a natural response by your body to fight off infection. Just like you cook food to kill germs in it, your body gets hotter when you are infected to make it harder for the infection to grow in you. This gives your immune system extra help to clean the infection out.
So what do you do for your child’s fever? Give them fever medicine, but give enough! Another popular reason for parents to visit the Emergency Department is that when they gave ibuprofen (Motrin, Advil) or acetaminophen (Tylenol, Pediacare), the fever did not go away. This does not mean the fever or illness is extra bad, or that the medicine is no good. After discussing dosing with the parents, the mom turns out to be afraid of overdosing their child, and then only gives a tiny amount. Therefore they under-dose the kid, and no wonder the medicine did not work. Don’t worry about overdosing with ibuprofen or acetaminophen- it is very hard to hurt a child with these medicines. If you have trouble figuring out the dose from the instructions on the bottle, call your doctor. The nurse on the phone can help you with dosing.
When is a fever a worry? As I tell my patients, its not the fever, or how high it is, or whether it goes away with medicine or not. Again, as I have said before, it is not the fever that will hurt your child- it won’t cook his brain or make him have seizures. What is more important is how the child is acting. Are they breathing normally? Good! Are they drinking and making urine? Good! Are they waking up and talking and with it? Good! These are the well enough-acting kids who can wait a few days before having to see a doctor, much less go to the Emergency Room.
The time we worry about fever is when children ACT sick. Are they getting short of breath, meaning they are pulling for their breath or breathing faster than normal? Are they getting more and more tired and sleepy? Are they drinking less and less? Kids who get sicker and sicker are the ones who parents need to call their doctors about. And if the doctors tell them to go the Emergency Department, come on in! Also, newborns with fevers need to get seen right away too. Newborns are at special risk for infections that older babies and children aren’t.
So next time your child gets a fever, don’t run to Emergency. If your doctor can’t see your child until the next day, it can wait! Talk to your doctor on the phone to be sure. Give ibuprofen or acetaminophen, and give enough. Fever is not the enemy, it is actually your child’s friend.