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

Thank you, I really appreciate it. Just hate seeing him like this. Hopefully, a bit of fluid and rest will help, but if not, I’ll get him seen.

No tepid baths and no fans, but do use anti pyretics, strip down to vest , in hospital we gave sugary juice - squash with sugar added to keep blood sugar up in the syringe its for a short time, and nicer than dioralyte which I have struggled to get any kid to take. 5ml ever 5 mins, whilst you wait for 111 to call back.

Has he got other symptoms that are causing a fever, - cold, cough, rashes, etc it’s worrying at this age but I always say best to err on the side of caution and get some advice than sit worrying.

There is some woeful advice on this thread. Crikey.

OP, it's very scary when our little ones have high temperatures, I can sympathise. Keep up with the Calpol and brufen, alternating between the two. I have found the brufen needs at least an hour to really kick in but often works better. Remember the temperature itself isn't a bad thing - it's the body's way of killing the virus/bacteria in the body. It's only a worry if it absolutely doesn't budge as it can cause convulsions in little ones.

Don't overdress him, but don't remove all of his clothes or use a fan or anything to drop his temp too quickly. Obviously watch for rashes and any drowsiness.

111 will likely send you to A&E to cover their back, but really, unless there are other symptoms starting or his temp doesn't budge at all, it might be a wasted visit and also a potentially long trip out of the house (where you'd all be more comfortable).

As a pp mentioned, ice lollies are great for getting the fluids in, and more appealing than water. Offer foods like cucumber and strawberries that are easy to graze on and are hydrating.

Good luck op x

My 18m old DS often gets a high temperature over 39/40 when he is poorly. He becomes inconsolable got about 20 mins. I used to really worry but not so much now. Nothing indicates a and e to me for your scenario but trust your Instincts too. Also try the orange book, it's from the NHS and tells you what to do.

Thank you for all the tips! I’ll try the sugary juice – sounds much easier than Dioralyte! He’s not got any rashes or cough, just the high temp and being really off his food and drink. I’ll keep up with the fluids and hopefully 111 will call back soon. Just don’t want to leave it too long if there’s something more going on. You’re right, best to be cautious at this age!

I know you’ve called now OP, but adding this in case anyone else is looking for advice another time.

In our area, calling 111 before 8pm will usually result in an OOH GP appt by 10pm. Calling any time after that usually results in being told to go to A&E. Always call!

Would he eat a popsicle? They sell Pedialyte ones here that you can give to get more electrolytes in.

Hopefully you can get an OOH GP appointment but if you're worried take him to be seen. Always trust your gut instinct. Hope he's better soon.

I wouldn't. He sounds ill but it doesn't sound like an emergency. Fevers can make anyone feel rubbish but rest is generally the best thing. If you can't get any liquids down him at all within 24 hours then I'd go in. But a day of not drinking loads won't do him any harm

I honestly wouldn't even ring 111 or get a GP appointment for this, if it's only been a day. 2 wet nappies is fine and doesn't signal dehydration. Whinging and being unsettled is typical with a high temp (think how awful it feels to have a fever as an adult). I know it's scary but even when you feel like they're barely taking on fluids, as long as you're seeing some wet nappies that's good. The syringe advice is good, as well as ice lollies.

I'd only seek medical advice if this went on for several days, or the crying became constant and inconsolable (screaming), or if the temp wasn't coming down with Calpol or ibuprofen. Or if there were other symptoms like a rash or bad cough/laboured breathing.

Not RTFT but neurofen/calprofen is better at keeping a temp down....111 have always been extremely reliable for swift advice, although have always sent to A&E when in hindsight not required..... if you are worried then go xxx

This was my thought exactly. Unfortunately saying your baby is out of sorts is hard to interpret because of course they are if they are ill.

No other symptoms to be worried about and very normal unfortunately for babies to get fevers.

Trust your instincts OP. While a high temperature alone doesn't warrant A&E, if you feel your LO isn't themselves them that absolutely warrants getting them checked tonight.

In the meantime, keep giving Calpol and Ibuprofen, offering fluids, and giving opportunities for rest.

Definitely try fluids with a syringe. A five ml syringe every five minutes will get a reasonable amount of fluid in. Juice is better than water as if they’re not eating then they need calories as well as fluid.

The advice to strip off clothing/tepid bath is outdated - fever is a protective mechanism driven by their immune system to fight infection so artificially cooling them just means their bodies will work harder to try and push their temperature back up.

Had this more times than I could count with my two children. TBH I’ve never even went to the gp unless it’s not settling after a few days. Keep trying with fluids, make sure you have some wet nappies even if they are not quite as well or heavy as usual. No rash or difficulty breathing/ fast breathing/ sucking in under the ribs etc. and they aren’t showing signs of pain such as inconsolable crying (generally wingeing and clinginess is to be expected when poorly) I’d probably just dose them up with calpol and ibuprofen and see how it goes for a few days. Any fluids are good fluids in this situation, even things you wouldn’t normally allow, ice cream, milkshakes, squash etc. lots of things like water melon, strawberries, cucumber, soup if they will eat it. Let them eat anything they are happy to eat even if it’s just cereal and toast. Don’t be worried about bad habits.

Still no call back from 111, which is frustrating. Been syringing fluids in as suggested, and he’s had a tiny bit, but still really lethargic and burning up. Temp hasn’t budged much even with nurofen. He’s just lying on me, whimpering, which isn’t like him at all. Really torn – don’t want to overreact but also don’t want to wait too long if he needs help.

Has anyone had to wait this long for 111 before? Not sure whether to just head to A&E now.

Also just to add if you are worried dehydration and are showing signs of actually being dehydrated (sunken fontanelle, no tears, dry mouth, and lips, no wet nappy for 8+ hours) all the hospital would do is give a fluid challenge, which would consist of giving 5mls of water via a syringe every 5 minutes for a few hours. They would be very very unlikely to give Iv fluids in a child this young u less absolutely necessary or in a situation where they are voniting constantly and not keeping anything down. You could do this yourself at home.

I know he's very little but when one of mine has a bad bug around the age of two and wasn't drinking a nurse advised me to let them eat some salty crisps and then they wanted water! I still use this tip :) also lollies if you have any in the freezer

I would go to an urgent care centre. They have GPs on hand and prioritise kids - I called 111 with my 2 yo with similar symptoms to this and they told me to go to urgent care right away. We got examined and antibiotics within an hour.

If there's no urgent care near you then A&E your best bet.

Another one not really understanding what the fuss is about here. Your child has a temperature and is a bit unsettled. They've had wet nappies today. What you've described does not warrant an A&E visit. Have you actually read the NHS advice for temperatures in children? That wouldn't suggest any action right now either. Having poorly children can be a worrying time, but you have to respond with calmness and have a certain tolerance for them being upset. Of course if anything changes, my response would change, but a temperature and a grizzly child in and of itself isn't a particular concern. Just keep offering fluids (via a syringe if that helps) and keep up with alternating nurofen and paracetamol

If he's lethargic, take him in. Worth looking at the signs of serious illness here. Sounds like he has ticked two of those, and I wouldn't take the risk.

www.nhs.uk/conditions/baby/health/is-your-baby-or-toddler-seriously-ill/

OP going against the grain, you’ve got him in front of you and are clearly worried. I’d take him in. I wouldn’t be surprised if he had tonsillitis.

Just take him in

Honestly just take him, your his mum you know him best