The Nurse’s Station: Fever
Welcome to our new series of Q&A on health issues that will help you make better-informed decisions for your and your family’s good health. We took a poll and asked people for topics of interest or questions they’d like us to answer. This month we look at fever, when to treat and when to be concerned.
Our health and wellness series,“The Nurse’s Station” column, is intended for educational purposes only.
Question:
“I have a growing family and all of us have had a fever on occasion. Sometimes it’s confusing when to be really concerned. What is a fever, why does it happen, and when should I be very concerned?” – A.L.
Answer:
Dear A.L.,
This is a great question for people of all ages. Let’s start with a simple definition of what a fever is:
A fever is a temporary rise in body temperature. It is only one part of an overall bodily response from the immune system. A fever is usually caused by an infection.
For most children and adults, a fever may be uncomfortable. But it usually isn’t a cause for worry. If the fever is accompanied with other mild but annoying symptoms, then over-the-counter medication could be used. Most fevers run a short course and resolve on their own in about three days.
Common symptoms with “low grade” fevers are:
- Sweating
- Chills and shivering
- Headache
- Muscle aches
- Loss of appetite
- Irritability
- Dehydration
- General weakness
Adults
There are different “normal” ranges of temperature depending on age.
For adults, an oral (by mouth) temperature of 98.6 F (37 C) is considered the average “normal”. It could be a little lower or a bit higher. An oral temp of 100 F (37.8 C) or higher is generally considered to be a fever.
Fevers below 104 F (40 C) associated with common viral infections, such as the flu, may actually help the immune system fight disease and are generally not harmful.
If the oral temperature is 103 F (39.4 C) or higher, call your healthcare provider for instructions. Seek immediate medical attention if any of these signs or symptoms accompanies a fever:
- Severe headache
- Rash
- Unusual sensitivity to bright light
- Stiff neck and pain when you bend your head forward
- Mental confusion, strange behavior or altered speech
- Persistent vomiting
- Difficulty breathing or chest pain
- Abdominal pain
- Pain when urinating
- Convulsions or seizures
Infants and toddlers
A fever is a cause for concern in infants and toddlers. Call your baby’s healthcare provider if your child is:
- A baby under 3 months old with a rectal temperature of 100.4 F (38 C) or higher.
- Between 3 and 6 months old with a rectal temperature higher than 102 F (38.9 C) or has a lower temperature but seems unusually irritable, sluggish or uncomfortable.
- Between 7 and 24 months old with a rectal temperature
higher than 102 F (38.9 C) that lasts longer than one day but shows no other symptoms. If your child also has other signs and symptoms, such as a runny nose, cough or diarrhea, you should call sooner.
Children
There’s probably no cause for alarm if your child over 2 years old does have a fever but is responsive, meaning your child makes eye contact and responds to your facial expressions and your voice, and is drinking and playing. Call your child’s health care provider if your child:
- Is listless, confused or has poor eye contact with you.
- Is irritable, vomits repeatedly, has a severe headache, sore throat, stomachache or other symptoms causing a lot of discomfort.
- Has a fever after being left in a hot car. Seek medical care immediately.
- Has a fever that lasts longer than three days.
- Has a seizure associated with the fever. Call 911 (or 101 in Israel) if the seizure lasts more than five minutes or your child doesn’t recover quickly.
Ask your child’s healthcare provider for guidance in special circumstances, such as a child with known immune system problems or with a preexisting illness.
What causes fever
Even when we are healthy, our body temperature varies slightly throughout the day. When your immune system responds to disease, the hypothalamus (the area in the brain that regulates temperature) can increase your body temperature. This starts complex processes that produce more heat and restrict heat loss. The shivering we might experience is one way the body produces heat. When we wrap up in a blanket when we feel chilled, we are helping our body retain heat.
Complications
Children between the ages of 6 months and 5 years are at increased risk of a seizure that occurs during a fever (febrile seizure). About a third of the children who have one febrile seizure will have another one, most commonly within the next 12 months.
A febrile seizure may involve loss of consciousness, shaking of limbs on both sides of the body, eyes rolling back or body stiffness. Although alarming for parents, the vast majority of febrile seizures cause no lasting effects.
If your child has a fever and experiences a seizure, here is what to do:
- Lay your child on the side or stomach on the floor or ground
- Remove any sharp objects that are near your child
- Loosen tight clothing
- Hold your child to prevent injury
- Don’t place anything in your child’s mouth or try to stop the seizure
- Call 911 or your local emergency number if a seizure lasts more than five minutes or your child doesn’t appear to recover well after the seizure
- Get emergency room or urgent care services if it’s your child’s first febrile seizure.
If your child doesn’t need emergency care, see your child’s healthcare provider as soon as possible for further evaluation.
A fever does not need to be feared when you have a better understanding of what it is and how to handle it. We wish you and your family only good health always and a happy, healthy and blessed sweet new year!
We welcome the submissions of your health and wellness related questions for consideration, to be researched and answered on this page in next month’s edition of UNORTHOBOXED Magazine. Your privacy will be protected. Send your questions to: miryam@unorthoboxed.com
DISCLAIMER:
“UNORTHOBOXED Magazine in general and this article series in particular, does not provide nor intend to give any medical advice. It is intended for informational purposes only. The author is a retired Registered Nurse, not currently in practice. The information offered is for educational purposes. It is not intended to take the place of your doctor’s recommendations. You are strongly urged to seek the advice of a trusted primary care physician or specialist. If your situation is urgent or critical, please seek the appropriate professional help immediately.”
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