Indications for symptomatic treatment of fever in children. When to reduce the heat?
A febrile child is much harder to examine and more difficult to interpret the results of the examination. The child is often agitated and makes poor contact, may be unconscious or behave inadequately. In such conditions it is difficult and tedious to conduct a detailed physical examination.
Physiological changes caused by fever, such as tachycardia and tachypnea, can mask the symptoms of diseases. If the patient still has tachycardia and after the temperature has normalized, then he needs to take an ECG to prevent paroxysmal supraventricular tachycardia.
If tachypnea persists after a decrease in temperature, an X-ray examination should be done to rule out pneumonia. On the other hand, if the child’s abnormal consciousness disappears after the temperature drops, then the spinal puncture can be avoided. According to Pizzo, the pulse rate usually increases by about 10 beats / min and the respiration rate by 2 cycles per minute for every 0.55 ° C increase in body temperature.
Despite the incomplete and contradictory data presented above, some conclusions can be formulated. Obviously, the fever does not always need to be treated, it is not always that the body temperature needs to be fully restored to normal levels.
However, in children aged 6 months to 5 years, when febrile seizures may occur, the fever must be treated. Fever should be treated in children with impaired function of the heart, lungs, kidneys, pathology of water and electrolyte metabolism.
Fever should also be treated in children with CNS diseases, especially those associated with infection or with increased intracranial pressure. Fever should be treated in patients with suspected or diagnosed sepsis or endotoxin shock. Finally, in some cases, it is necessary to treat a fever to improve the general well-being of the patient. The indications for the symptomatic treatment of fever are given below.