A&E or wait for GP – 16mo poorly

[vitjab1988]

Hi all,

Looking for some quick advice – not sure if I should take DS (16mo) to A&E tonight or wait for the GP tomorrow. He’s had a high temp (39.5°C) since this afternoon, calpol brought it down a bit but it’s creeping back up. He’s also very clingy and not himself, whimpering a lot. No rash, breathing seems OK, but he’s refusing fluids and only had a couple of wet nappies today.

Would you wait it out or go in? I don’t want to overreact but also don’t want to leave it too long if he needs help.

TIA x

Can you call 111 and get some advice from them.

Go. I have primary school kids and I have only taken them once each but in this situation I would go.

I think if he’s refusing fluids and temperature is going back up, I would go.

Call 111. They should offer an out of hours doctor's appointment rather than sit in A&E .

Try a tepid bath to calm and bring that temp down, the majority of discomfort will be associated with high temp, give the calpol as advised on the bottle.

A walk in the pram, or a ride in the car might settle them,

You've said no breathing issues or rash, he's not lethargic. Try bringing the temp down and see how he is after the bath

I'd ring 111, you'll more than likely end up with GP OOH contact

I personally wouldn’t take a child in just for a high temperature (I say this as someone who gets sent to A&E a lot for temperatures as a complication of treatment I’m on for another condition, it’s miserable). I would offer calpol and ibuprofen alternating and see how that controls the fever. A fever that can be controlled at home isn’t really an emergency. But I would take him in if there are other worrying signs - febrile seizure obviously, if he is hard to wake, worrying rash, clearly in pain, fever does not come down, etc. Re-assess in the morning and get an urgent GP if you think you need it then. GP was able to refer direct to paeds so we went straight to the ward for assessment rather than A&E.

DO NOT try a tepid bath.

This is dangerously outdated information.

Call 111

What is your particular concern.

A fever is a generalised symptoms that comes with most illnesses. If he's refusing to feed give pain relief to see if this helps, if it's back teeth or a sore throat.

The fact he isn’t taking in fluids and the high temperature would signal to me that getting in contact with your gp out of hours service, 111 or A&E - not peeing in such a little one is a worry and I would not leave that. Better to go and for them to say it’s nothing major than to leave it in my opinion. I hope your baby feels better soon.

https://www.nhs.uk/conditions/fever-in-children/

Call 111, whilst you wait as they may give an OOHs appt try ibuprofen for the temps instead as long as no allergies..tends to work better. Also anything he will have fluids wise very frequent, sips of very dilute squash, ice pops will help.

I also think 111 as you may get an out of hour GP appointment rather than a very long wait in A and E. I hope he feels better soon x

I was thinking about calling them, but I’ve heard mixed things about how long they take to get back to you. Has anyone had a quick response from 111 recently? Don’t want to sit around waiting if we’re just going to end up in A&E anyway.

If there's been wet nappies today then it's not dire dehydration so I wouldn't go to a&e. Call 111 if worried, they answer the calls quickly and give advice based on how urgent they think it is. But if you're really worried then just go, they won't mind (I just wouldn't want to be sat in a&e all night, no way you'll get seen quickly as wouldn't be a high priority)

I'd definitely call 111 and not just wait for GP though - also means if it gets worse you can call back and they'll fast track you a bit I think - if they think you need a&e they'll tell you right away

I personally wouldn’t rush to A&E with just a fever, especially if it’s being brought down with calpol. What I did was alternated calpol / nurofen (mine are late teens now so not sure if that advice has changed). I’d have had a lot of A&E trips if went in with a high temp. I would definitely call 111 first, I would have thought this is an out of hrs GP issue, not A&E so I don’t think you’d be wasting your time ringing them. Obviously if symptoms changed whilst waited for a doc to call then i’d go to A&E buf as things stand, I personally don’t think it’s an A&E issue, but obviously i’m just going on what’s written here, and your call. Try syringing in some water if he is refusing to drink water. Hope he’s on the mend soon

I wouldn't go to A&E for that. A temperature is normal reaction to being a bit unwell and of itself is not alarming, though of course you should watch him closely.

Do not follow the tepid bath advice or otherwise try to make him cold.

You can alternate paracetamol and ibuprofen if you think he needs it.

Obviously if his behaviour changes and he is screaming a lot, or becomes very sleepy (and it isn't bed time), consider a trip to A and E. In the meantime, if he isn't taking fluids perhaps his throat is sore- try an ice lolly?

@vitjab1988 you need to get baby's temp down. you do not want a febrile convulsion happening. temp is nearly 40degrees more calpol if within the reasonable time and get yourself with baby to a/e now. take off clothes and try to cool them a bit. do you have a fan/

If not drinking then you can give water from syringe.
Trust your instinct - if you are worried then best to get him checked over.

Try sips of water/milk every few minutes, they will likely say to do this in an and e anyway. Also ice lolly as pp said x

I've had a quick response from 111 whenever I've had to call with my daughter, and offered OOH GP appointments (even at 2am). It does seem to differ based on your area though. I wouldn't go to A&E for a high fever personally, but I would go if there were no wet nappies or any other signs of dehydration. I hope he perks up soon- it's such an awful worry when they're poorly!

I second not going to A&E
Also the advice about alternating ibuprofen and calpol (my DS once had a stubborn fever that calpol didn’t do much for but baby nurofen worked wonders)
If the above does not work in bringing down the temp, seek medical advice

Also - 111 prioritise call backs for kids under 5

This is ridiculous

Hi op, just linking the latest nhs guidance on caring for a little one with fever as there’s some outdated advice being shared here: https://www.nhs.uk/conditions/fever-in-children/.

I hope your DS is feeling better soon. How soon is the temp coming up after calpol? I prob wouldn’t take a child in if their temp came down with calpol but you can never be too careful. I’d call 111 and see what they suggest - we did this before with DD at 3 and they got us an ooh appointment