It me again, poorly dd2 (seem to be posting here a lot lately)

[Marne]

Dd1 is getting over the flu, i have come down with it (this morning) and now dd2 .

I am worried sick as dd2 often ends up in hospital when she gets ill due to not being able to control her temp. She has Autism but no other health issues (so did not have the flu jab), she's only 4 (my baby) so i worry about her so much.

At the moment her temp is 39.0, i have given nuforen and calpol but her temp has not budged , i have taken her clothes off and opened a window (only a little because its very windy out). Is there anything else i can do to stop her getting any hotter (her temp often peeks at 41.0). She seems quite alert at the moment, she's led on the sofa but still talking (to herself).

[winnybella]

Wet towel on forehead and/or wrapped around her calves.

[Mrsfred]

Poor you. Both of mine get really high temps, like yours.

I do everything you have done, plus put a fan on them and tepid water flannels on their faces, back of their necks and under their arms.

Do you have any ice lollies. I know they don't eat when they are unwell, but mine can be persuaded to lick them which sometimes helps.

Hope she is feeling better soon.

[Sawyer64]

Don't let her shiver as this will make her Internal or Core temp rise...

Loose cotton clothing is best.

Regular Nurofen and Calpol will control the temp,takes about 30-40 mins to see a result.

Nurofen is better for lowering a childs temp,but both is fine,preferably 1-2 hours apart...ie.Nurofen now and calpol 1-2 hours after.Then Nurofen in another 6 hrs,etc.

You can try Tepid sponging although these days they don't recommend this,but as long as it is tepid,not cold,as this will cause goose pimples which is the bodies way to generate heat.

[Marne]

Thank you, i'm not sure if she will let me put anything wet near her but i will try.

How much calpol can i give her, i only have 6+ so have given her half the dose (she is a large 4.9 year old).

[TheUnmentioned]

If her temp goes up I would call NHS direct.

I know how worrying it is, ds had flu (confirmed as flu a) at xmas - his temp was 40 with calpol and nurofen. He isnt prone to high temps and I was so so worried.

He is ok though.

It did take him a long while to get better and watch out because his temp dropped marginally on day 4 (his birthday :( ) and by day 6 (xmas day) it was on its way up and he wouldnt eat and had developed pneumonia. He got put on antibiotics though and it cleared it up.

She will be ok just keep and eye and if you are very concerned ring NHS / OOH.

[Marne]

cross post

She had nurofen an hour ago and have just givin her calpol (in her drink as its the only way i can get it into her).

[Sawyer64]

oh and plenty of fluids.....

[TheUnmentioned]

Also, if she is large for her age it may be worth seeing a doc anyways. We had to as ds is a very big (just) 4 year old and needed 15ml (instead of 10) of the under 6 calpol and 6ml (Instead of 5) of the calprofen.

[TheUnmentioned]

Also, try and do nurofen and calpol at 3 hourly intervals so for example...

7-nurofen
10-calpol
1- nurofen

etc etc

This should mean you arent left with a big gap when you cant give anything.

[Marne]

Thank you, i will try to get her to bed soon as her room is nice and cool (no heating in her room). I will phone the out of hours doc if she gets worse (temp goes up).

[Sawyer64]

You are doing all you can then...If you keep the meds regular then she should be fine.

The difficulty with taking the Older Calpol is the concentration of calpol is stronger in the 6+,so halfing the volume doesn't always work as they are still getting the higher dose.

Better to get the right age one IMO,perhaps a friend or someone could pop one in to you.

[Marne]

Thanks Sawyer, i havn't got any fiends near by, just my mum who is also getting over the flu , i might have some other calpol lurking in my cupboard (will try and find some).

Just put her to bed, she seems happy (just very red faced) and her temp has gone down to 37.8 so hopefully she will sleep.

[sneezecakesmum]

Make sure you are giving the maximum according to the bottles. GPs (and me!) can give weight related dosages but its not ethical on MN.

Calpol infant 120 mg = 5 mils
age 1 - 6 = 1 - 2 5ml doses) 2x5mls = 240 mg (max dose)

4.8 mls of your calpol 6 plus is the equivalent of 2 x 5ml spoons of calpol infant.

Does that make sense??

[sneezecakesmum]

Have done sum on calculater and in brain and its come out the same - hate it when no one to check!!! Pretty sure its correct tho!

[Marne]

Thank you sneeze- that makes ense. Is there anywhere on the net where i can look up weight related dosage?

She's asleep now and temp has gone down but i'm worried it will peak again (as it did with dd1).

[sneezecakesmum]

If you register on BNF childrens (british national formulary) it will give dosages, but must reiterate should be via doctor.

[sneezecakesmum]

I have cut and paste the section for you so it is correct, just in case you cant get into BNF. Its not difficult to work out but we always get someone to double check any figures.

Severe pain; severe pyrexia (but see Cautions)
?By mouth
Child 1?3 months 20?30 mg/kg as a single dose then 15?20 mg/kg every 6?8 hours; max. 60 mg/kg daily in divided doses

Child 3?12 months 20?30 mg/kg as a single dose then 15?20 mg/kg every 6?8 hours; max. 90 mg/kg daily in divided doses

Child 1?6 years 20?30 mg/kg as a single dose then 15?20 mg/kg every 6?8 hours; max. 90 mg/kg daily in divided doses

Child 6?12 years 20?30 mg/kg (max. 1 g) as a single dose then 15?20 mg/kg every 6?8 hours; max. 90 mg/kg (max. 4 g) daily in divided doses

Child 12?18 years 1 g every 4?6 hours (max. 4 doses in 24 hours)

CAUTIONS; -

Cautions: alcohol dependence; high risk of liver toxicity with high doses; interactions: Appendix 1 (paracetamol)

Hepatic impairment dose-related toxicity?avoid large doses; reduce infusion dose in hepatic impairment to max. 3 g daily

Renal impairment increase infusion dose interval to every 6 hours if estimated glomerular filtration rate less than 30 mL/minute/1.73m2

Pregnancy not known to be harmful

Breast-feeding amount too small to be harmful

[TheUnmentioned]

Please dont work out the weight related dosages yourself - you should sepak to a doc if it comes to that.

[sneezecakesmum]

Feel like I'm in a hole and still digging.

When it refers to 'single dose' this is the loading dose and is only given if no other paracetemol has been given in the previous 24 hours.

Again should be prescribed by doc.

[dikkertjedap]

Hi, sorry to hear your dd is poorly, I am just back from hospital as my dd was hospitalized with secondary infection.

I would:

• maximum amounts of calpol and calprofen for her age ideally spaced out over 24 hours but if temp rapidly increases then give whatever you can still give her whilst observing the four hour period between doses of the same medicine
  
• fan if you have one
  
• light loose cotton pyjama or T-shirt and underpants or nothing at all
  
• cover with cotton sheet
  
• make sure she does not get so cold she starts shivering/shaking as this can further increase temp
  
• personally I would not spunge or open windows TBH
  
• do you have a drinks bottle with a straw? Fill with water and anytime she is slightly awake she can have a little sip (or after you have given medicine), many sips still add up nicely
  
• take her in your bed so you can keep close eye on her
  
• write down all medication you give her with times and her temperature on sheet of paper as would be helpful if you need to take her to A&E (sorry, just because just happened to us, hopefully wouldn't happen to you)
  
• in case she sweats a lot, make sure you change her so she doesn't stay in wet clothes
  

This is all I can think about. Hope she gets better soon. Such a worry.

[Marne]

Thank you, dikkertjedap- hope your dd gets better soon , we managed to get dd's temp under control and kept it down all night, she seems a lot better this morning but not 100%, me on the other hand, i am in bed with flu ( horrid cought, soar throat, aches and it feels like someone is sitting on my chest) .

It makes me angry that children are not being vaccianted against flu (another sad story on the news las night as 2 more children die from SF).

[dikkertjedap]

Agree, this flu is so horrible. And they can deteriorate so quickly that is my greatest worry as I am far from OOH/A&E, the worry not being in time as we were only just in time two weeks ago.

[Marne]

A&E is almost 25 miles from us , dd2 has been ok all day and now her temp is back up to 40 and i can't get it back down (given nurofen an hour ago). My temp has shot up too .

When do you know that it is serious enough to go to A&E? I often end up in A&E with dd2 only to be told theres nothing they can do other than give calpol.

[sneezecakesmum]

Marne. I would ring your out of hours docs. Do all the stuff dikkerj suggests. Are you yourself taking maximum doses - cocodomol and ibuprofen (if tolerated)? The aching bones and headache/sore throat need maximum painkillers so stick to 24 hour maximum doses and you will feel better (only marginally-sorry)

If DD has been fairly bright all day and has drunk loads of fluids, is weeing well, dont worry too much. Temperatures rise normally in the evening so it is aggravating the fever response. Hope you now have infant calpol and giving 2 (5ml) spoons? with the brufen?

A&E if no urine for 6-8 hours, becomes excessively drowsy, talking nonsense (confused) not liking light/stiff neck/rash, rapid struggling breathing, pale, lilacy lips, capillary refill >2 secs. (press the nailbed with your fingernail until it goes white. It should become pink in under 2 seconds when you remove the pressure)

[dikkertjedap]

Yes, as sneeze is saying, plus A&E if they start coughing continuously without breaks because at one point they simply run out of oxygen and then it is downhill very very quickly. I suppose you could also take her pulse, but I must say I am not very good at that myself, maybe somebody else has advice on how best to do it.

Hope you will get better soon, but it is such a worry.