Measurement of body temperature
1.What factors can affect the measurement of body temperature?
Whether the body produces more heat or dissipates heat poorly, it can cause the body temperature to rise, such as drinking a lot of hot water, exercising, soaking in a sauna, spending a long time in the sun, wearing too much clothing, etc. If you want to make sure that you are not sick and have a fever, you must avoid these factors and sit down for 15 to 30 minutes before taking your temperature.
2.What are the benefits of electronic thermometers compared to traditional mercury thermometers? Is the measurement accurate?
If regularly calibrated, the temperature measured by an electronic thermometer is no different from that of a mercury thermometer. However, mercury thermometers are not suitable for general household use, mainly because of the risk of mercury poisoning and environmental pollution due to accidental breakage of mercury thermometers. Currently, Taiwan has stopped using mercury thermometers to reduce accidental injuries and environmental pollution.
3.How long does it take to measure body temperature with a thermometer?
The general electronic thermometer will beep about 1 minute after starting, then you can read the temperature. Experts recommend measuring the oral temperature for at least 2 to 5 minutes, the axillary temperature for 3 to 10 minutes, and the anal temperature for 1 to 3 minutes.
4.Is it accurate to feel a child’s skin to see if there is a fever?
The method of feeling the skin to determine if a child has a fever is very inaccurate, so when a child is sick, a thermometer must be used to correctly determine if the child has a fever. According to foreign research, mothers can only correctly determine 74% of children with fever by hand, while the correct rate of nursing staff is only 42%.
5.There are many different ways to take the temperature, which one is more accurate?
The methods of temperature measurement include anal temperature, oral temperature, axillary temperature, back temperature, ear temperature, forehead temperature, etc. Among them, the anal temperature is the closest to the real internal temperature of the body. Ear temperature correlates well with anal temperature and can replace anal temperature when necessary, but it must be noted that ear temperature correlates poorly with central body temperature in infants under three months of age. Oral temperature is on average 0,5 degrees Celsius lower than anal temperature, and axillary temperature is on average degrees Celsius lower than anal temperature, and both are more susceptible to low levels due to factors such as vasoconstriction of the skin mucosa. For newborns under one month old or with very low body weight, it is not suitable to measure anal temperature and ear temperature, and axillary temperature or back temperature can be considered. The accuracy of measuring the skin surface with a forehead temperature gun or infrared light is poor.
6.What is the correct way to measure anal temperature?
Wash the thermometer first with soapy water or alcohol, rinse Q with cold water (do not use hot water), and rub a little Vaseline and other lubricants on the end. The best position is to place the child in a prone position with the abdomen facing downward and place the child on an adult’s lap or bed, holding the child’s lower back above the buttocks with one hand and sticking the thermometer into the anal opening at a depth of about 0.5 to 1 inch (about 1.5 to 2.5 centimeters) with the other hand. Electronic thermometer in the rest of about 1 minute, after the beep sound can be read.
7.What do I need to pay attention to when taking oral temperature?
Children over 5 years old can use this method to take their temperature. It is not advisable to drink hot or cold water for 15 to 30 minutes before the measurement to avoid measurement errors. Wash the thermometer with soap and water or alcohol, and then rinse it with cold water (do not use hot water). Turn on the electronic thermometer switch, place the induction end under the child’s tongue and leave it for about 1 minute, the thermometer will be read after the beeping sound.
8.What do I need to pay attention to when measuring ear temperature?
The accuracy of the thermometer is poor for infants under three months of age. When measuring, you must pay attention to the correct angle of the ear temperature gun on the e-side of the ear, as excessive ear wax may interfere with the measurement. If you have otitis media or other middle ear abnormalities, your ear temperature may be inaccurate and you should use another method to take your temperature. The ear temperature gun must be calibrated regularly to avoid loss of accuracy. When measuring, place the sensor end of the ear thermometer into the external ear canal and press the activation button to read the data within a few seconds. When the temperature of the two ears differs, the higher temperature should prevail.
The meaning of fever
1. How high is a fever when the body temperature is above a certain level?
A fever is defined as a central body temperature ≥ 38°C. A body temperature between 37, 5°C and 38°C may be normal or low grade fever, and it is necessary to refer to the temperature measured before and after and other symptoms to determine whether there is a fever.
2.Why do people have fever?
There is a thermoregulatory center in the inferior optic thalamus of the human brain, where a temperature locus is set, and the temperature is usually set at about 37OC when you are not sick. When the human body has an inflammatory response to various diseases such as infections, some small molecules created by the inflammatory response will act on the thermoregulatory center to raise the body temperature locus, and the human body will then perform many physiological reactions to raise the body temperature. There is another situation where the body is not inflamed and the temperature locus does not rise, but the body temperature rises because the body has too much heat to dissipate, this situation is called hyperthermia, such as wearing too many clothes in a hot environment, wrapping the baby too tightly, exercising, taking a sauna, heat stroke, etc.
3.Why do children have cold hands and feet when they have a fever?
A: When the inflammatory reaction causes the temperature locus of the inferior colliculus to rise, the normal body temperature recognized by the brain will exceed 38 degrees Celsius. If the body temperature does not reach the set standard, the patient will feel cold and may involuntarily experience muscle tremors to increase heat and vasoconstriction of the extremities to reduce heat loss, so the phenomenon of cold hands and feet will occur.
4. Is there any benefit of fever to human body?
Many studies have shown that moderate fever can enhance the effectiveness of the immune system, but some studies have also shown that antipyretic drugs can suppress the immune response, so in animal experiments with large amounts of antipyretic drugs can increase the mortality rate of sepsis. When humans are sick, fever is considered a protective instinctive response, aimed at strengthening our resistance to disease.
5.Is there any harm to the human body from fever?
Fever requires extra heat production, so it increases oxygen consumption, carbon dioxide production and heart output. In addition, some children may suffer from fever between the ages of 6 months and 6 years due to physical factors that can lead to febrile seizures.
6. Will a fever burn the brain?
Fevers below 41°C do not cause direct damage to the brain or other organs of the patient, while extremely high fevers can sometimes cause varying degrees of abnormalities in consciousness. Generally speaking, it is said that fever can burn children’s brains out because those children suffer from diseases such as encephalitis and meningitis, etc. Fever is only one of the symptoms of these diseases, but what really affects the brain is a serious brain infection.
7.If there is still fever after using antipyretic medicine, does it mean that the antipyretic medicine prescribed by the doctor is not effective?
Some people think that if they have a fever after taking antipyretic medication, it means that the medication prescribed by the doctor is not effective, so they will go to other doctors, resulting in a waste of medical treatment. In fact, fever is one of the phenomena that occurs after illness, and many diseases can cause fever. When a child has a fever, he or she should bring it to a doctor to find out the cause of the fever and treat it. The effect of all kinds of antipyretic drugs only lasts for a few hours, and their use is aimed at bringing a short period of comfort to small children. Most common respiratory or gastrointestinal viral infections have no specific medication, and some of these viral infections may last for one L or more. Fever is an important indicator of a changing disease process, and blindly reducing a fever can create a false impression that may lead to misdiagnosis. If the fever does not go away, it is important to continue to seek medical attention to find out if there is any other specific cause of the illness, rather than blaming the prescribed fever-reducing medication for being ineffective.
Ways to reduce fever
1. Since fever can enhance the effectiveness of the immune system, should we not reduce fever at all?
If the cause of the rise in body temperature is not an inflammatory disease, then this high body temperature does not help the body and can be reduced at any time, such as excessive clothing, heat stroke and other high body temperature. As for fever caused by inflammatory reactions, if the body temperature is not too high and does not cause special discomfort, it is not necessary to actively reduce the fever, especially if the body temperature does not exceed 39°C or more. Experts recommend that fever reduction be considered in the following cases above 38°C.
(1) Chronic lung disease, adult-onset respiratory distress syndrome
(2) Chronic anemia
(3) Diabetes and other metabolic abnormalities
(4) Patients who have had febrile spasms or seizures
(5) Pregnant women
(6) other fever and discomfort symptoms
2.Which of the various fever-reducing methods, such as ice pillows, cooling patches and fever-reducing pills, is more effective?
In the past, alcohol bath was used, because the rapid evaporation of alcohol will cause rapid contraction of blood vessels on the surface, and alcohol, such as inadvertent inhalation of children will have the risk of poisoning, but also hinder heat dissipation, so should not be used to reduce fever, other fever reduction methods can be divided into physical fever reduction methods (including ice pillows, low temperature blankets, heat dissipation patches attached to the skin surface, warm water bath) and drug fever reduction methods (including oral, anal plugs, injections The fever-reducing drugs) two. Ice pillows and other physical methods of fever reduction can only accelerate heat dissipation, and will not correct the abnormal rise in the localization of brain temperature caused by inflammatory reactions. This is like saying that when we have a fever, our brain will think that 38°C or higher is the normal body temperature, ice pillows and other physical methods of fever reduction against the brain’s settings and let the heat loss, is like setting the temperature of the water heater at 100°C, plugging in to increase the temperature on one side, but keep throwing ice cubes in, not only will the patient have the discomfort of cold, but also will increase unnecessary energy consumption. So inflammatory diseases should not use physical fever-reducing methods such as ice pillows, but rather fever-reducing drugs that can correct the localization point of the brain temperature. For patients with metabolic diseases, chronic heart and lung diseases, chronic anemia, etc., who cannot cope with the sudden increase in energy demand, which may lead to the collapse of metabolic mechanisms or heart and lung failure, the risk of using ice pillows is even higher in such patients with fever. In cases of high body temperature, such as too much clothing, heat stroke, etc., the brain temperature locus is normal and only heat production and heat dissipation are out of balance, and only then can physical fever reduction methods be used.
3.Is there any fever-reducing effect by injecting a drip or drinking a lot of water?
The fever caused by inflammatory disease has no effect on reducing fever. Therefore, if the process of fever and fever reduction is repeated too many times, it is easy to become dehydrated due to heavy sweating, so special attention should be paid to the proper replenishment of water and electrolytes at this time.
4.Is there any fever-reducing medicine that should not be used by children?
The use of aspirin in children may harm the liver and brain and lead to Reye’s syndrome, so aspirin should not be used as a fever reducer in children under the age of 18. The main chemical structure of aspirin is salicylic acid, so other fever-reducing drugs containing salicylic acid should not be used in children under 18 years old, including various oral or injectable fever-reducing drugs that contain salicylic acid. The injectable antipyretics currently available in Taiwan are mainly composed of salicylic acid and should not be used in children under the age of 18. In addition, antipyretics such as dipyrone (anandamide) and phenylbutazone (botrytisone), which are derivatives of pyrazolone, may cause fatal white blood cell hypoglycemia and are prohibited for all ages.
5.Which ingredient of fever-reducing medicine is better for children?
Currently, the fever-reducing drugs available for children in Taiwan include acetaminophen, ibuprofen, diclofenac, etc. The duration of action and fever-reducing effects of these drugs are similar, and the main difference is the type of side effects they may cause. The use of these antipyretic drugs must be careful dosage, any kind of antipyretic drug overdose is not safe.
6. Is there any difference between oral and anal antipyretics?
There is no significant difference in the duration of action and fever-reducing effect between oral and anal medications, but it is recommended that children should use oral medications first. Anal plugs should only be considered if there is severe vomiting or if the child refuses to take the medication. There is no theoretical basis for the belief that oral or anal fever reducers should be used only when the body temperature reaches a certain standard or higher.
7. What should I be aware of when using acetaminophen as a fever reducer?
The recommended dosage of acetaminophen for children is 10-15 mg per kg orally every 4-6 hours. The dosage of acetaminophen for children is very different from that of the adult form, so it is important to pay attention to the label and avoid overdose. The lowest single toxic dose is 120-150 mg/kg, which can cause liver failure in the event of an overdose. In addition, there is a risk of kidney damage with prolonged use of this drug. This drug has no gastrointestinal, coagulation or immune suppression side effects, so it is recommended that the following patients be given priority for use.
(1) Coagulation abnormalities and other bleeding tendencies
(2) Upper gastrointestinal diseases such as peptic ulcer or gastrointestinal bleeding
(3) Patients who have undergone surgery or have visible wounds for other reasons
(4) Severe infections
8.What do I need to pay attention to when using isobutyleneacetic acid as an antipyretic?
The recommended dosage of ibuprofen for children is 5-10 mg per kg orally every 6-8 hours. This drug is a non-steroidal inflammatory inhibitor and is commonly used in China in the form of oral syrup. Possible side effects include stomach upset, upper gastrointestinal bleeding, reduced renal blood flow, and inhibition of platelet coagulation.
9.What do I need to pay attention to when using diclofenac as an antipyretic?
Diclofenac is also a non-steroidal inflammation inhibitor and is commonly used in China in the form of plugs, with the same possible side effects and precautions as ibuprofen.
10. Is it possible to alternate between two or more antipyretics?
In a few cases of severe inflammation, the effect of one antipyretic may be limited. Therefore, without violating the various antipyretic principles listed in this recommendation, alternating the use of two antipyretics may be considered in special cases, but in principle, it is not recommended to give two or more antipyretics at the same time.
11. What should be noted about the use of antipyretic drugs in patients with G-6-PD (glucose-6-phosphatedehydrogense deficiency)?
Exposure to highly oxidizing drugs in patients with this condition may cause destruction of red blood cells and lead to hemolytic anemia. There is no significant risk of hemolytic anemia if acetaminophen and non-steroidal inflammatory inhibitors are used at the correct recommended doses. However, there is a risk of hemolysis when high doses of non-steroidal inflammatory suppressants are used for rheumatic diseases, such as aspirin at 80 mg/kg/day for Kawasaki disease.