To take DD back to a&e

[Advice54321]

A couple of days ago my 9 month old seemed a little off and spiked a temperature of 39.2, calpol was only keeping it around the 39 mark. Called 111 who said to take her to a&e. Got there and it had risen to 40.1.

They checked her over, everything was fine although her throat was a little red but nothing that should make it spike like that. Took a blood sample and gave her iv antibiotics whilst we awaited the results. Her temp dropped and she perked up almost immediately.

Bloods came back and the docs words were “there is nothing there concerning, we think she has tonsillitis. We are going to send you home with antibiotics but if her temperature isn’t under control after two days, come back.”

Her temperature is now under control, probably too low if anything at 35, so I can’t give anymore calpol or ibuprofen.

But she still just isn’t right. She won’t play, she just sits there having a cuddle and randomly she cries out. She throws herself around and might settle in an awkward position for a bit before crying again. I probably managed to get her on the floor playing 3 times in the whole day for about a minute each time before the crying started again.

I wasn’t sure if she was just over tired last night so thought I’ll put her to bed and see in the morning. She just woke up for a feed and it’s taken me an hour to get her back to sleep as she was just crying and throwing herself around like she doesn’t know what she wants.

She’s had 3 full days of antibiotics (as apparently the iv antibiotics count as a full day) and am wondering what to do if she is the same in the morning. I don’t know if I’m over reacting and need to give the antibiotics longer to work, or if I’m under reacting and should be taking her back.

Just FYI if a child that age is off you can still give them paracetamol even without a temperature- she might be in pain!

Absolutely agree you've done the right thing. Always better to go in and be checked. Hope your little one is ok.

Always try to take your child's temperature when they are well so that you have a baseline to know what is normal.

My own body temp is the high end of 35, Dh and both our children also the high end of 35. We have it written down, taken about once year in the medicine box with the thermometers, I have two different ones, one under the tongue one and one temple one from years ago.

I hope your DD gets better soon. It is awful when they are so little and they cannot tell you how they feel precisely.

Hopefully she’s on the mend.

My DS was a bit extreme with temps as a baby. He was in hospital on iv antibiotics twice with sepsis like symptoms and blood results. He had viral things on both occasions but his temp would be 40 plus initially and then fall into the 35s once he started to get better. He had several further viral things with temps as high as 40 plus then dropping quickly.

It’s always worth being seen to rule out sepsis but can just happen in some children without a serious underlying cause.

I was asked to ‘present’ the symptoms on his various admissions to a group of medical students at our local surgery- coordinated by one of the practice partners. They had to give their opinion on what investigations they’d do in each case and what they were suspecting was the cause.

It was a really interesting session. We’d actually seen the practise partner GP on both occasions with our DS each time before he was admitted and so she was able to feed in info about our DS clinical presentation.

They’d all rightly determined that he needed to be treated for sepsis as precaution as the numbers said yes (temp, blood markers- CRP, resp rate, heart rate, vomiting, poor feeding etc) but his visual presentation said possibly not (well perfused, alert, fairly settled etc).

They take no chances basically is the upshot. And they also really listen to parents. On both occasions the GP asked me are you worried about him? Do do think he’s really unwell? As parents instinct is usually right with these things. (On both occasions I didn’t think he was seriously unwell but I knew it needed checking out and thankfully it turned out to be the case).

Sorry to hijack OP and hope some of the above is useful.

[quote Advice54321]@blackcat86 can I ask how you know that? Just my understanding was from when a doctor told my sister she was slowly killing my niece one dose of calpol at a time, by lowering her body temperature too much.[/quote]
This is nonsense.

But regarding your DD, go back as you have concerns.

But you haven't lowered her temperature too much by giving Calpol, that's just not possible.

@SD1978

And any doctor who says pain relief causes hypothermia is an arse who should be struck off..........

Yes but I'd be willing to bet no doctor said this, or anything close.

Always get checked again. Trust your gut. Definitely take her back x

Ah, the classic 'looks terrible at home, cheers up as soon as they see the doctor' - you still did the right thing in taking her to A&E, they were always lovely to me when I took my baby in & doctors are keen to reassess little kids when they don't seem right, things can change very quickly.

@weddingwonders

Echoing others, please take your daughter to hospital, I'm studying medicine and a low temp is absolutely a sign of sepsis.

Please stop panicking the OP with sepsis. I absolutely agree that she should bring her baby back for further examination.

However, low OR high temperature is ONE of the signs of sepsis, which would need to be accompanied by a number of other symptoms.

I'm not a medical professional so I'm not going to advise one way or the other but saying that (as a medical student) low temperature on it's own is a marker for sepsis is really foolish.

I had a low temperature spike with my daughter once and it was scary. The out of hours doctor stayed on the phone to me for ages. I hope she continues to improve.

Missed OP's update before I posted - glad you went back OP & that your DD seems brighter. Good to get her fully checked out

Tonsillitis is horrible, it can recur quickly. Antibiotics do work of course but some people need two courses, a different one next time. Have a look in her mouth at the back of her throat and see if there is red, raised swelling. If there is, take her back, otherwise give her plenty of fluids and wait a while. She has been unwell and it takes a while to recover but hopefully she will perk up tomorrow.

I would definitely have more than one thermometer! I had a very expensive in ear one that always seemed to give the wrong temperature (too low). I had another two which were always accurate. Also, you can test them by checking your own temperature and your partners or whoever else is in the house. My in ear one said we were all way below normal!

Low temp is a marker for sepsis though @EarringsandLipstick there is a huge campaign for parents not to wait and to have ANY sign of sepsis checked out straight away, even with a lack of other symptoms. Many children have died as initial symptoms were dismissed and a bereaved family have done a huge push to ensure ANY of the symptoms prompt investigation. In fact in my local health board parents are actively encouraged to ask 'could it be sepsis?' Glad so many others on the thread recognise the signs and would seek help! Hope your little one makes a speedy recovery OP.

On the topic of sepsis, here’s a link to the Sepsis Trust info on some of the things you should be alert for. Sepsis is a devious thing to spot and we should all be aware of some of the signs sepsistrust.org/about/about-sepsis/

Yes, it's one marker. So is high temperature.

Posters were writing as if low temperature on its own was a significant symptom of sepsis. It's not.

Absolutely a parent with any concerns should get their child checked out again.

However, if the only symptom is low temperature, it would be highly unlikely to be sepsis. Of course, don't take any chances, and always seek medical advice.

But the repeated posts about sepsis and the issue of low temperature were inaccurate and capable of causing unwarranted anxiety.

Sounds very similar to what happened with my dd, also iv antibiotics, took oral ones for 5 days, wasn't herself for 72 hours then right as rain. Yes see someone just in case but I wouldn't worry too much

Hope she gets sorted it’s so scary when they are poorly

No @EarringsandLipstick you're wrong. You do not need to wait for a second symptom to appear alongside a low temperature. However you twist it, downplaying symptoms is exactly the opposite of what we're encouraged to do.

You also have absolutely no way of saying what diagnosis is likely or unlikely, the PPs suggesting that it could be sepsis are doing the right thing by encouraging OP to take her child to A&E.

OP don't withhold pain relief from your child, no doctor told your sister that she was killing her child one dose at a time with calpol. Honestly.

What a doctor may well have said, is that giving calpol at the first sign of a grizzle, or every afternoon for an overtired toddler, is not wise. Surprisingly many parents do this, it gets into a habit and the child and parent tend to rely on it. If a GP noticed that, they may have attempted to discourage it.

I hope your DD feels better soon!

You also have absolutely no way of saying what diagnosis is likely or unlikely, the PPs suggesting that it could be sepsis are doing the right thing by encouraging OP to take her child to A&E.

Please read my posts again Denver.

I absolutely encouraged OP to take her baby for further medical treatment.

I explained that low temperature is NOT some kind of unique symptom of sepsis, as some ill-informed posters said. Low OR high temperature is a symptom of sepsis, along with others. If a parent has any concerns, they should take their child to a&e / gp as applicable.

The manner in which the posts were written was seriously misinformed.

Definitely best to head back, I never take chances with the kids. Sounds like she's happily showing you up in the waiting room as they always do!

Its most likely the thermometer isn't quite getting far back enough in her ear, they are built for adults so for under 1 you pull ear straight back and for child up and back. Some peoples ears are just built where you have to ram it right in to get an accurate reading. If could be helpful in future to keep a cheap underarm/oral thermometer in the house and if you get an off reading double check it against the armpit one. Most accurate is rectal but don't recommend that on a regular basis!

I am gad your daughter is feeling better I hope she is seen soon. My son would get temperatures over 40 regularly (prob had it 40 plus times before he was 5) and we were often in A&E. I agree with other posters - capol lowers temp to normal not below normal. Sometimes kids temperatures in the early morning are lower than during the day naturally but you should definately get her seen.