Help! High temp!

[SleepyCaz]

DS, aged 4 is currently in bed, half asleep, half delirious, with a temp of 38.8. He is on his fourth day of having chickenpox.

Early this morning they looked much better so took him and his sister to the park. I know, stupid thing to do. He had factor 50 on all day and wore his hat and t shirt.

However since going to bed at 7pm his temp has rocketed and Calpol hasn't brought it down. He now has the elec fan in his room and is sleeping on top of his quilt. He's a bit shivery though.

DH was livid when he got home and said I was stupid for taking him out in the 25 degree heat for 2 hours and that I have damaged him and made him very very ill. In my defence I didn't expect it to get as hot as it did and I got home pretty sharpish, but it was via bus. I'm an idiot, he's right. I just thought that a bit of sun would help him feel better and he'd been cooped all week, during the holiday. I really feel shit for him.

Does the fact that Calpol hasn't cooled him off mean I need to get him checked out? I just read online that sun was BAD for CP. I had no idea. Any tips for bringing his temp down? Can't believe what a bloody fool I am.

[TurtlesAreRetroRight]

NHS guide to fever in children here.

[hmc]

That's funny turtle - my gp recently advised me both to sponge down and alternative calpol and ibruprofen. Do you have medical training (not meant to sound as adversarial as it does - genuine question)

[rathlin]

I didn't think you were supposed to bring high temperatures down by putting children into cool water/sponging etc as you can cause vasoconstriction so that the body thinks it is cold and retains even more heat thereby making the temperature worse. You also need to be careful with a fan if it makes the air too cold....it should be kept well away from the child and only used to move the air around.

[winnybella]

ah, yes, didn't see that bit-on the second page it says if a child is less than 3yo with 39 degrees and for older children to go by their behaviour. So they seem to contradict themselves a bit. But how the child behaves is much more important from how high the actual fever is- you can get minor infections with fevers over 40.


From Seattle Children's Hospital:

Home Care Advice for Fever

1.
Reassurance: Presence of a fever means your child has an infection, usually caused by a virus. Most fevers are good for sick children and help the body fight infection. Use the following definitions to help put your child's level of fever into perspective:
*
100°-102°F (37.8° - 39°C) Low grade fevers: beneficial, desirable range
*
102°-104°F (39 - 40°C) Mild fever: still beneficial
*
Over 104°F (40°C) Moderate fever: causes discomfort, but harmless
*
Over 105°F (40.6°C) High fever: higher risk of bacterial infections
*
Over 106°F (41.1°C) Very high fever: important to bring it down
*
Over 108°F (42.3°C) Dangerous fever: fever itself can harm brain

[hmc]

I said tepid not cool. Important distinction

[sundew]

I thought you weren't supposed to do the cold bath thing anymore - but have always been told by my GP to alternate calpol / nurofen as required to get the temp down (taking care of course to not go over the daily limit for either). If Temp is very high they can be given together. DD2 has migraines and has been told by her consultant to take max dose calpol + neurofen together (so must be OK).

[hmc]

Agree winnybella - that you have to look at whole picture. My ds recently had a high temp but was pretty lucid so I wasn't as worried as I would have been if he had been disorientated / hallucinating etc

Well this thread has shown there is a lot of conflicting advice out there

[SueSylvesterforPM]

Any local walk in health centres near you??

[TurtlesAreRetroRight]

Nope, no medical training at all. I've had to go on a couple of courses though and I provide respite care for 2 children who suffer febrile convulsions. All of my advice comes from their paediatrician and is backed up by NICE and NHS guidelines. They are reviewing the guidelines because there is some evidence for the efficacy of alternating the two but there haven't been enough trials into the safety of doing so. As I said in my message, a HCP may advise you to alternate where there is a medical need to do so and it's a useful thing to do when you do need that double dose approach but is at the discretion of who you see. BUT as routine you should not do it. It's not advised and like I said you start with one, switch to the other if it's not working and then seek further medical help.

And you don't sponge down. This advice has been outdated for quite a long time down. It lowers the temp too quickly and is more dangerous in some ways than a temp (febrile convulsions are caused by the speed a temp rises for example, not by a temp itself). If you sponge them you make them cool too quickly. They then shiver. The shivering tells you that their body is fighting to raise the temp again and quickly. This up down up down effect can make a child unwell in itself.

[whydobirdssuddenlyappear]

The conflicting advice on cooling a temp with cold water is exactly why you need to find out if this is cp related or if it's heat exhaustion. Because, according to the nhs website, cold water is still recommended for heat exhaustion.

[hmc]

Mental isn't it - what is a lay person to do!

[TurtlesAreRetroRight]

Yes heat exhaustion is a completely different kettle of fish and you NEED to cool the person down and QUICKLY. I would never give advice on it as I don't have enough experience or knowledge except to know that it's serious and I think, though don't quote me on this, that it's one of the reasons for calling 999 pretty quickly if you can't get the temp down. It's not within the remit of normal childhood illness/temps at all.

I did have a friend years ago who had heat exhaustion (or heat stroke I really don't know tbh, like I said am clueless) and was hospitalised and put in an ice bath. So she said anyway. I think it's an entirely different matter.

[whydobirdssuddenlyappear]

I know. Not easy, is it. In the case of my ds, it was bloody obvious it was heat exhaustion, though, and he had no other underlying illness to worry about. Even so, I put him in a bath that was just not quite as hot as he was, and then gradually reduced the temperature, as I thought it would be too much of a shock to his system to put the poor little mite straight into freezing cold water.

[whydobirdssuddenlyappear]

Yes, heat exhaustion's a totally different kettle of fish from a temp caused by illness (body can't cool itself down, rather than body trying to heat itself up). But given it's been so hot, it's yet another possibility in the list of why SleepyCaz's ds is so poorly (little children don't sweat as much as adults, so can be more prone to it). On the other hand, it could be the chickenpox causing it. Whatever the cause, really, if his temp won't shift at all, and he's delirious, it'd definitely be best to call the doctor to find out what's likely to be the problem, and to get him checked over.

[SleepyCaz]

Hello everyone. Thanks very very much for such helpful posts.

Have just been back in to see DS. (Went in to move his fan further away )He feels almost normal temp-wise and is snoring away.

Do you think it's safe to go to sleep now? Me, I mean.

[TurtlesAreRetroRight]

I'm glad he seems better.

It's a judgement call in terms of going to sleep. I personally sleep in the same room as dd if she's at all ill and check her regularly as and when I stir. But that's just the way I prefer to do things regardless.

If the fan's on (but not directed towards him), he's cool and comfortable and you can hear him if he stirs then there' no reason not to get some sleep. If you can. It's still bloomin' hot.

[whydobirdssuddenlyappear]

I'm glad he's cooled down! I'm with Turtles. I think I'd sleep, but in the same room as him, just to be on the safe side.
Hope he's fully recovered in the morning.

[isthismadness]

If he's delirious call ooh doctor/nhs direct for advice
He could have a secondary bacterial infection, a different infection entirely that is hidden by the pox (you can get two things at once!) or heat exhaustion

Please call rather than listening to people on the internet.

It's the delerium with the fever I would worry about

[TheOriginalFAB]

How is he now?

[SleepyCaz]

Hi all.

He was absolutely back to normal this morning. Spent the day playing happily with his Sister, ate like a horse and is now in bed. His spots seem to be on the way out today too. I slept on a ready bed in his room.

Thanks to all of you who replied :)

[whydobirdssuddenlyappear]

Ah, fabulous. Glad he's better.

[winnybella]

Great

[ChrisR77]

I know that I'm cross-posting this, but I thought I'd post on all the top MN links from a Google search:

NOT good - last night, despite us saying it was DEFINITELY chickenpox (her sister had it 2 weeks previously), NHS Direct advised that we give my 4yo daughter Nurfoen to reduce her 40C temp... and her chicken pox was a LOT worse than this boys': www.dailymail.co.uk/health/article-3530325/Horrific-pictures-NEVER-child-chickenpox-ibuprofen-Boy-left-fighting-life-developing-blood-poisoning.html

3x more spots... focussed around her neck, ears, eyes, scalp...

The out of hours GP and A&E* doctors' faces just went grey when we said that was the advice, until we re-assured them that we HADN'T! She had rapidly accelerating localised skin infection over more than a third of her body, that would have VERY quickly turned to septicaemia with Nurofen.

*(before I get flamed - we DIDN'T go to Paed'A&E directly - we were referred by the emergency GP and ushered straight into a secluded isolation room)