Two-year-old Ming has had a fever for two days and his body temperature has been close to 39 degrees Celsius at its highest every day. Xiao Ming’s parents followed the doctor’s instructions, giving him plenty of water and giving him oral antipyretics when his temperature exceeded 38.5 degrees Celsius, as well as warm water baths to cool him down. Although the antipyretic effect seemed to be good at the time, the child’s body temperature would rise again a few hours after taking the medicine. Although Xiao Ming had no other symptoms such as cough, shortness of breath and diarrhea, besides a little runny nose, and his spirit and appetite were the same as usual, his parents were still very worried, especially his grandmother, who kept muttering that the child had been feverish for such a long time, and that if he didn’t hurry to the hospital to get an IV to bring down his temperature, then his brain would be “burned”. The problem is big.
Can a child’s fever really burn his brain or leave any after-effects? When a child has a fever, what are the issues to be alert and pay attention to? With all these questions, early in the morning, the apprehensive mother rushed to the pediatric emergency room with Xiao Ming in her arms. The doctor diagnosed that Xiaoming was suffering from a common pediatric upper whistle infection, and after giving the appropriate medication, Xiaoming quickly recovered. The first of a series of questions, through several consultation and review of relevant information, Xiaoming’s mother also got a satisfactory answer.
Appropriate fever may be more conducive to recovery
The thermoregulatory center located in the hypothalamus of the brain regulates the heat dissipation and heat production of the body to achieve self-balancing of body temperature. Under normal circumstances, the anal temperature of children is 36.5 to 37.5 degrees Celsius, and the axillary temperature is 36 to 37 degrees Celsius, higher in the evening than in the early morning, and slightly higher after crying, eating too much and strenuous exercise. Especially in newborns and small infants, because their thermoregulatory function is not yet mature, external temperature, crying, breastfeeding, clothing thickness and other factors may cause fluctuations in body temperature.
Fever is caused by the upregulation of the thermoregulatory center. When viruses and pathogenic bacteria (including some vaccination vaccines) invade, in order to resist these foreign substances, the body will immediately start a series of defense mechanisms, such as rapid mobilization of leukocytes and lymphocytes with bactericidal effect to the site of infection. The fever is one of the most important signals of the body’s defense system.
A child can be considered to have a fever when he or she feels hotter when kissed or touched on the forehead, and when the body temperature is found to be more than 37.8 degrees Celsius in the anus or 37.5 degrees Celsius in the armpit. This is a common sign of many pediatric diseases and an immune, physiological response of the child’s organism to defend against inflammation and resist viral or bacterial invasion. From this point of view, fever is good for annihilating the invading virus or bacteria, inhibiting their growth and reproduction, as well as increasing the immune activity of T lymphocytes and enhancing the stress response of the organism. Therefore, to a certain extent, pediatric fever is not entirely bad, do not take antipyretic measures too aggressively, but may be beneficial to the child’s recovery (this is the main reason why doctors advocate not using antipyretic drugs for fevers below 38.5 degrees Celsius).
Brain fever is rare
However, in real life, we find that parents are often anxious when their children have a fever, trying to bring down the child’s body temperature quickly, and some are even worried that the child will burn the brain. In fact, fever and brain damage are often not simply caused by the fever itself, the majority of pediatric infections are common endogenous infections, which cause fever, the body temperature rarely exceeds 41 degrees Celsius, this type of fever does not cause brain cell damage, resulting in brain damage.
As for fever that may involve the brain, it is usually seen in cases of encephalitis, meningitis, sepsis, etc.; or super high fever (body temperature often close to 42 degrees Celsius) during heat stroke, which leads to irreversible heat denaturation of brain cell proteins.
There are rules for cooling fever
When a child has a fever, a temperature between 37.5 and 38 degrees Celsius is considered a low fever, 38 to 39 degrees Celsius is a medium fever, over 39 degrees Celsius is a high fever, and over 41 degrees Celsius is a super fever. Generally speaking, when the body temperature does not exceed 38 degrees Celsius, there is no need to reduce fever urgently, especially before a clear diagnosis is made, blind use of antipyretic drugs may cover up the condition and interfere with the diagnosis; when the body temperature reaches 38.5 degrees Celsius or above, consider reducing fever under the guidance of a pediatrician.
If the body temperature is below 38.5 degrees Celsius, it is best to use physical cooling. For example, drink more water, put the child in an environment with a room temperature of 21-22 degrees Celsius, and let him wear as little clothes as possible, so that the skin can cool down through conduction and convection with the air and radiation heat dissipation. In addition, you can also use warm water and alcohol (ethanol) bath. Specifically, you can use 75% medical alcohol (ethanol) to double the warm water, soak a small towel and take it out, scrub the sick child’s neck, armpits, thigh roots, hands and feet for a few minutes each. Attention should be paid to.
① Do not rub the chest, abdomen and other places to avoid excessive drop in body temperature.
② The same area should not be repeatedly wiped continuously. Because the skin will absorb part of the alcohol (ethanol), children with imperfect liver function are prone to alcohol (ethanol) poisoning. When a child has a fever with chills, do not rush to use physical cooling, so as not to increase the child’s discomfort.
When the axillary temperature is higher than 38.5 degrees Celsius, then fever-reducing drugs such as Merlin (ibuprofen), Tylenol (p-acetaminophen), pediatric fever-reducing patches and pediatric fever-reducing suppositories can be used under the guidance of a doctor. Chinese medicines such as Chai Hu, Pediatric Niuhuang San, Zi Xue Dan, Antelope Horn and Qing Fever Relief Oral Liquid can also be used as appropriate. However, it should be noted that excessive use of antipyretic drugs in infants and young children within 3 years of age can easily induce convulsions and deficiency, and even lead to damage to the digestive system and liver and kidney functions, so they should be used sparingly.
For those whose body temperature exceeds 39.5 degrees Celsius, diclofenac sodium suppositories can be used for anal plugging, intramuscular injection of compound aminopyrine and other antipyretic drugs, and ice saline enemas to lower the temperature. If the fever reaches 40 degrees Celsius or above and is accompanied by hyperthermic convulsions, hibernating drugs such as chlorpromazine and promethazine should be considered. For parents, the need for an immediate visit to the doctor or aggressive heat treatment should be determined based on a combination of the child’s age, physical and mental status at the time of the fever. If the child’s temperature does not exceed 38.5 degrees Celsius and he or she can lie comfortably in bed, immediate treatment is generally not necessary; however, if the child is distressed, irritable or agitated, even if the temperature does not exceed 38.5 degrees Celsius, active treatment should be given.
In addition, a high percentage of infants and young children have febrile convulsions, and repeated convulsions can cause damage to brain cells and may be a precursor to some epilepsy, which can lead to other risks. Therefore, any child with a history of febrile convulsions or a family history of fever should be given immediate heat treatment as soon as a high fever develops.
It is also important to remember that
It is important to be aware that if the fever lasts too long or the temperature is too high, it will speed up the metabolism and cause the body’s energy consumption, making infants and children more prone to dehydration, which is detrimental to the central nervous system and may even be life-threatening. Infants and children have a less stable temperature center than adults, and common viral infections can lead to fever of nearly 40 degrees Celsius, especially in young infants under 6 months of age, where fever often means a serious infection. In all of these cases, parents should take their children to the doctor immediately.
Many parents think that their child will be fine once the fever has subsided with some medication, but some diseases are prone to recurrence or complications after the fever has subsided if they do not receive further treatment for the cause, such as anti-infection. For example, children with urinary tract infections, otitis media or pneumonia are especially prone to recurrent fever. Therefore, when your child’s temperature exceeds 41 degrees Celsius or has recurrent fever, you should be especially careful and take your child to the hospital quickly for a checkup so that you can understand the cause of the fever and actively do targeted treatment.
Tips: Antibiotics should not be abused
Some parents take it for granted that when a child has a fever, an infusion is faster than taking medicine to reduce the fever, so they ask the doctor to give the child an infusion and ask for antibiotics as soon as they arrive at the hospital. In fact, in pediatric clinics, fever and inhalation tract infections are mostly viral infections in the early stages, and antibiotics do not have any effect on viruses. Instead, inappropriate infusions can produce adverse reactions. Therefore, clinically, antibiotics are only considered when antiviral drugs cannot reduce fever, or secondary bacterial infections, significantly higher blood white blood cell count, or more serious infections such as pneumonia.