Myth 1: The higher the fever, the more serious the disease; In the fixed ideology of the family, the higher the temperature, the more serious the disease, and clinically, we often encounter children with high fever who are seen in the emergency room. In our daily clinical work, we often encounter families holding their children in the doctor’s office and shouting: “Doctor, my child’s temperature is very high, 39.5℃, save him quickly. However, when we look at the child, we find that the child is generally in good condition and in good spirits, and the temperature can be quickly reduced after giving oral antipyretics. The condition of children with good mental condition is usually not serious. Fever is the most common symptom when a child has a cold, and is a way for the body to fight against pathogenic microorganisms. Generally speaking, the more intense the fever, the stronger the body’s resistance. For infants and children <3< span=""> months old, high fever rarely occurs even with serious infections, such as pneumonia and urinary tract infections, because the immune function is not yet developed and the resistance is not strong. Therefore, the degree of fever does not positively correlate with the severity of the disease. If a child with high fever is in good spirits, eating normally and moving well, the condition is usually not serious. On the contrary, they may be mentally depressed or drowsy, reluctant to eat, impossible to drink water, infants under 3 months old may appear to eat less, move less, have a change in skin color (pale, gray skin), or even moan in severe cases, and generally now such symptoms are indicative of a more serious illness. It is also important to note that there are indeed many serious infectious diseases that can be accompanied by persistent high fever. Myth 2: Blindly listen to family members’ advice and give antipyretic drugs when they encounter fever; Some family members are often prone to blindly listen to other family members or some doctors’ opinions that once a child has a fever, he or she should take oral antipyretic drugs, or even two kinds of drugs for 38℃ and 38.5℃ (in fact, both drugs are different preparations of the same antipyretic drug). Whether to use drugs to reduce fever must be based on the degree of fever, (axillary temperature as the standard) body temperature in 37.5-38 ℃ for low fever, 38-39 ℃ for medium fever, 39.1-41 ℃ for high fever, > 41 ℃ for ultra-high fever. Low fever is a protection for the body, >37℃ is not conducive to the reproduction of pathogenic microorganisms. If the body temperature is still >38.5℃ after physical cooling, it is better to use antipyretic drugs, because the neurological system of children is not yet mature and can easily trigger febrile convulsions (children with previous convulsions and a body temperature >38℃ are best treated with medication to reduce fever). Sustained hyperthermia can lead to increased consumption of oxygen and nutrients in the body, which increases the burden on the organs and can easily cause dysfunction of vital organs, especially the heart and brain vessels. Hyperthermia can lead to brain cell damage, coma and even death. Encephalitis and ultra-high fever due to heatstroke are emergencies and need to be dealt with actively. Myth 3: Physical cooling methods are not in place; physical cooling for fever is a simple but effective measure, many people understand the physical methods of reducing fever, such as drinking more water, warm water wipes, etc., but to the specific implementation may not be in place in the details, the following to explain in detail. Drink more water to replenish body fluids Some children with fever are reluctant to drink water due to various reasons such as throat discomfort. Various juice drinks are available, but plain water is best. Warm water wipe, not alcohol wipe Warm water wipe is a good cooling method, the temperature of the water is 34-37 ℃ is appropriate, suitable for children of all ages. Each wipe should be applied for >10 min, with the focus on the skin folds, such as the neck, armpits, elbows, groin, etc. For children with high fever or who are older, a warm bath with water slightly cooler than body temperature is acceptable. It is important to note that many people use alcohol baths for pediatric fever, which is incorrect! Because the skin of infants is very thin, alcohol is very permeable, and after absorption through the skin, symptoms of alcohol poisoning may occur. Alcohol rubbing baths can also stimulate the skin, causing capillary constriction and hindering heat dissipation. It is generally not used for children, especially small infants. Lowering the ambient temperature, but not for all children Fever reduction in children requires heat exchange with the surrounding area. A suitable ambient temperature is conducive to fever reduction, and the best ambient temperature is 20 to 24°C to bring the body temperature down slowly. For small infants, especially in summer, their body temperature will drop slowly if they are left open and placed in a cool place. It should be noted that this method is not suitable if the early stage of fever in the child is accompanied by chills and chills. Fever patches have a limited effect on reducing fever Fever patches have a limited effect on reducing fever due to their small size, and they are comfortable for children with high fever and are an adjunctive measure. Ice packs are not suitable because they are too cold and may cause capillary constriction of the child’s skin, preventing heat dissipation. In particular, ice should not be applied to children with chills and chills. More excretion is good for fever reduction Drinking more water and urinating more is a good way to take away body heat. If the child has no stool on the day of the fever or for several days, you can use an open plug to eliminate the accumulated food residue in the body, excretion at the same time take away the heat to reduce the high fever, many Chinese medicine is to use this approach to complete the fever, Chinese medicine is called to clear the heat of the lower jiao, these Chinese medicines will generally contain rhubarb, gypsum, guavas, betel nut, etc. Myth 4: The medicine with good antipyretic effect is good medicine; if the child still has a high fever after drinking more water and physical cooling, you generally have to use antipyretic drugs. Some people think that a good antipyretic effect is good medicine, but it is not, must take into account the adverse effects of the drug. Generally speaking, the antipyretic effect of antipyretic drugs and adverse reactions are directly proportional, the better the effect, the greater the adverse reactions. The adverse effects of antipyretic drugs are summarized as gastrointestinal symptoms such as irritation of the gastric mucosa, destruction of appetite, aggravation of gastric ulcers and even bleeding; excessive doses can lead to liver and kidney damage, and can also induce blood disorders; for severe allergic reactions, manifesting as critical conditions such as exfoliative dermatitis. Therefore, it is important to understand the characteristics of different drugs and take into account the therapeutic effects and adverse reactions in order to reasonably select the appropriate drugs. Commonly used antipyretic drugs and their clinical characteristics are as follows. Acetaminophen has a fast onset of action, but the control time is shorter than other drugs, with an average control time of about 2 hours. However, there are relatively few adverse effects, such as gastrointestinal reactions, platelet function and granulocytopenia, which are common with other antipyretic and analgesic drugs, and there is no nephrotoxicity, so it is safe and widely used in clinical practice, especially in children <2 years old. The drug has obvious dose-dependence, that is, the efficacy rises with the dose, but do not overdose, 10-15 mg per kg of body weight per dose, to avoid liver damage. Ibuprofen This drug and acetaminophen are both recommended by the World Health Organization for use in children as antipyretics and are also safer drugs. Ibuprofen is characterized by its smooth and long-lasting antipyretic effect, which is stronger than acetaminophen for high fever and lasts longer than acetaminophen, averaging about 4-6 h. Ibuprofen has little effect on gastrointestinal irritation and platelets, and common adverse effects are mild gastrointestinal reactions, increased transaminases, and occasionally coagulation, etc. Reversible renal injury is occasionally seen in states of dehydration, low blood volume and low cardiac output. Overdose may cause central nervous system depression and seizures. Dosage: 5 to 10 mg/dose per kg body weight. Aspirin Aspirin is a non-steroidal anti-inflammatory, analgesic and antipyretic drug, which is no longer used as a routine antipyretic drug in clinical practice. The compound salt of lysine and aspirin, which can be used for intravenous injection, has fast onset of action and good efficacy. Its adverse effects are mainly manifested by liver function damage, jaundice, central nervous system symptoms and renal damage. Nimesulide is a new type of non-steroidal anti-inflammatory, analgesic and antipyretic drug successfully developed and marketed in Italy in 1985. The outstanding advantages of nimesulide compared with ibuprofen are better antipyretic effect and less digestive system adverse effects. However, there are increasing reports in the literature that the application of nimesulide can cause severe liver damage. Due to the ongoing controversy, its use has been restricted in China in children <12 years of age. Nimesulide is a non-steroidal anti-inflammatory and analgesic drug with strong and long-lasting antipyretic effect. Due to the high incidence of adverse reactions, this drug has different degrees of toxic side effects on liver function, kidney and blood system. Therefore, it is not used in general, but can be used occasionally under medical supervision only when the child has persistent high fever or febrile convulsions. Anacin is an old antipyretic drug with rapid antipyretic effect, which has been used less frequently in recent years due to more serious adverse effects such as granulocytopenia and kidney damage. Currently, 27 countries have banned or restricted the use of Anacin. Only in the case of acute hyperthermia and acute illness, and there is no other effective antipyretic drugs available, it is used for emergency antipyretic, oral administration is no longer used. Many Chinese herbal medicines have different degrees of antipyretic effects, but since the antipyretic effect of Chinese herbal medicines is slow and the drug components are not well known, parents are not recommended to use Chinese herbal medicines as antipyretic drugs. In summary, acetaminophen and ibuprofen are the best choice for reducing fever, because they are relatively effective, have few adverse effects, and are basically safe at normal doses. Myth 5: Failure to properly analyze the condition; When a child has a fever, in addition to measuring the child's body temperature, you need to pay attention to the following conditions Pay attention to the child's mental status If the child is in good spirits, it indicates a mild infection. If the child is not in good spirits, drowsy, yellowish or dark, this is usually a sign of serious infection. For example, in toxic dysentery, the child's main manifestation is a bad complexion and poor mental health, and may only have nausea and vomiting, not diarrhea, but the condition is serious and can easily be combined with toxic shock. Note the accompanying symptoms. This article only lists relatively common cases. Presence of rash and bleeding spots on the face and trunk Many viral infections have a rash in their early stages, such as chickenpox and rubella. Rashes that appear during fever include scarlet fever and measles. If bleeding spots appear early in the fever, exclude epidemic meningitis. Presence of diarrhea and urine If the child has diarrhea, ask whether the diarrhea appears before or after the fever. If it appears before fever or within 1 d after fever, it suggests an intestinal infection; if it appears a few days after fever, it may be a comorbidity of the disease or an adverse reaction to medication. For those with significant diarrhea during fever, especially mucus-purulent stools, it is recommended to collect stool samples with pus and blood or mucus in a carton or plastic bag when going to the hospital to facilitate laboratory tests. Stool from diapers should not be used as a specimen for testing. It is also important to pay attention to the abnormal color of the child's urine. If the fever is accompanied by soy sauce-colored urine, it indicates the presence of hemolysis in the child, suggesting a serious condition. If there is significant abdominal pain, especially if the child cannot walk straight, or if the abdominal pain does not allow him to rub his stomach, consider appendicitis. Because the symptoms of appendicitis in children are sometimes atypical, they are prone to perforation and co-infection of the abdominal cavity. Pay attention to the epidemiological situation. Pay attention to the surrounding area for similar diseases, especially during epidemics of infectious diseases, such as hand, foot and mouth disease. If the child is surrounded by children with the disease, consider HFMD if the child has a rash or blisters on the mouth, throat, or hands and feet, even if the symptoms are not typical.