Fever in toddler

[achootigersmall]

Need some advice as I'm rubbish at this stuff. Ds 3 temp is moving between 38.1-38.5. He had calpol at about 4pm. It hasn't brought it down really and he's so hot to touch. He won't drink any water but has had some ice lollies and a smoothie.
He's grumpy and irritable (as expected) I'm just not sure what the next step is as temp isn't coming down much? This is the first proper temperature we've had, and he's never ill so I don't know what to do?

How old is he, and how does he look? also check out the 'home care' advice from NICE:

1.6 Antipyretic interventions

1.6.1 Effects of body temperature reduction

1.6.1.1 Antipyretic agents do not prevent febrile convulsions and should not be used specifically for this purpose. [2007]

1.6.2 Physical interventions to reduce body temperature

1.6.2.1 Tepid sponging is not recommended for the treatment of fever. [2007]

1.6.2.2 Children with fever should not be underdressed or over-wrapped. [2007]

1.6.3 Drug interventions to reduce body temperature

1.6.3.1 Consider using either paracetamol or ibuprofen in children with fever who appear distressed. [new 2013]

1.6.3.2 Do not use antipyretic agents with the sole aim of reducing body temperature in children with fever. [new 2013]

1.6.3.3 When using paracetamol or ibuprofen in children with fever:

continue only as long as the child appears distressed

consider changing to the other agent if the child's distress is not alleviated

do not give both agents simultaneously

only consider alternating these agents if the distress persists or recurs before the next dose is due. [new 2013]

1.7 Advice for home care

1.7.1 Care at home

1.7.1.1 Advise parents or carers to manage their child's temperature as described in section 1.6. [2007]

1.7.1.2 Advise parents or carers looking after a feverish child at home:

to offer the child regular fluids (where a baby or child is breastfed the most appropriate fluid is breast milk)

how to detect signs of dehydration by looking for the following features:

sunken fontanelle

dry mouth

sunken eyes

absence of tears

poor overall appearance

to encourage their child to drink more fluids and consider seeking further advice if they detect signs of dehydration

how to identify a non-blanching rash

to check their child during the night

to keep their child away from nursery or school while the child's fever persists but to notify the school or nursery of the illness. [2007]

1.7.2 When to seek further help

1.7.2.1 Following contact with a healthcare professional, parents and carers who are looking after their feverish child at home should seek further advice if:

the child has a fit

the child develops a non-blanching rash

the parent or carer feels that the child is less well than when they previously sought advice

the parent or carer is more worried than when they previously sought advice

the fever lasts longer than 5 days

the parent or carer is distressed, or concerned that they are unable to look after their child. [2007]

As he is three, and the temp is over 38 C and not coming down, the OOH doctor will probably check him over for you if you call. Otherwise, you can alternate calpol and nurofen (which tends to be better at bringing down temperatures) and see whether it makes a difference first of all.

Hope he is ok.

Nhs choices is a nice easy information website for every illness or symptom that toddlers/kids throw at you.

Connected to NICE guidance so research based, but easy to read and understand. Have a look.

Loads of info on how to treat & when to seek medical advice x hope this helps.

There's always 111 who are there 24 hours a day for advice.

He's fallen asleep on my lap, going to get some Nurofen in a sec. temp is rising 38.7. So hot to touch.
I'm worried about meningitis although I'm sure it's nothing like that!
Going to get some nurofen down him and see how he is in half an hour.

Bear in mind it may take about 45 minutes calpol or ibuprofen to work.

Have you checked him all over for a rash? Can you wake him easily? Is he stripped off? Just nappy/pants, nothing else.

Have a look on nhs choices for symptoms of meningitis.

He's more likely to have ear/ throat infection, brewing a cold or cough, simple childhood stuff.

I have checked him all over no rash. Just had nurofen he's just in a nappy, he woke up and was crying but he's back to sleep now. Temp was at 38.9 when nurofen was given will keep checking on him if hasn't gone down within 30-45 minutes I'll be ringing 111.

Sounds good, keep up with fluids, ice pops etc. Also keep an eye on nappies, nice wet nappies regularly are good.

Be reassured that a high temperature is the body's normal natural response to infection, bugs don't like heat, the body is very efficient heating up to kill bugs. He is doing everything he should

Thank you what do I do about fluids as he won't touch water at the moment for some reason, but he did have a couple of ice lollies earlier and an innocent smoothie. If he refuses to drink anything more what do I do?

Whatever you can get into him, ice lollies galore, smoothies, jelly, juice anything. Don't necessarily have to get water into him, just fluids.
As long as he has wet nappies, all good.
111 are available all night if you need them, if anything changes or gets worse, or even if you just want to talk to someone xxxx

I have used the calpol syringe before now, 2 syringe full of juice every half an hour or so.

That's a good idea to use the syringes as he'll take the medication as he knows it will help him feel better, so might use them to do water every so often.
Thank you it helps to talk to people with rational thoughts , as I just want to rush him to a&e although I know it's probably 99% not needed right now.

Always worth a call to 111 if your unsure, my dd at 18 months was like this, nothing brought her temp down, she had tonsillitis, not a sign of anything apart from the temperature. Always worth getting little ones checked.

Put a vest on him - leaving the surface of the skin cold only makes the body try and heat up iyswim, which will just maintain the fever.

Doesn't really matter what fluid you get into him, just get some in. So orange juice, jelly, ice lollies, ribena whatever. Maybe give 111 a call for reassurance but I wouldn't be too worried (unless other symptoms like rash or persistent vomiting). My DS always goes for 40+ temps when he's ill so I have become a bit more relaxed about anything below 40 (rightly or wrongly) but you know your child. And it's never a waste of hcp time if you seek advice.

Ah orange I didn't know that! I'll put a vest on him now thank you!

Not sure I can see anything really concerning here. Fever is not that high and he has taken fluids.

Unless he gets worse in some noticeable way, you just need to wait until his immune system deals with the probable virus.

Never nice when a small child is ill, though.

That's what I need to hear Larry I'm just jumping to something terrible is wrong as he's never ill, temp is slowing dropping thankfully! Seems like nurofen is kicking in!

Don't panic. Fevers aren't usually dangerous. Warning signs for serious illness are too sleepy, not responsive, or a rash that doesn't go away when you stretch the skin. Let him sleep it off and don't panic about bringing it down. A fever is the body's way of making the environment inhospitable for the virus. It's scary, I know, but most of the time it will go of its own accord.
Nurofen and Calpol alternated every 2 hours will help.
DON'T sponge him down.

Sorry can I say that nurofen is NOT 4 hourly, it's 8 hourly, calpol can be Given 4 hourly.
Read the label carefully, I also recommend that you jot down the time that you gave the medicine so you can calculate when the next dose is due, I forget. Especially on little sleep.

Nurofen is not 8 hourly. It's no more than 3 doses in 24 hours. Assuming a child will sleep for 12 hours it's ok to give those 3 doses 4 hourly while the child is awake.

Calpol can be given 4 hourly but no more than 4 doses in 24 hours.
Nurofen can be given 6 hourly, but no more than 3 doses in 24 hours.
Be weary of giving nurofen on an empty tummy. A drink of milk or few sips yoghurt can line the tummy.
You need to look out for reduced urine output, cold hands and feet, drowsiness, mottled or pale, clamminess.
How is the temperature now?

It's come right down, nurofen really worked, do I give him another dose of calpol now as he can have some more? get it before it spikes again or leave it Until later? It confuses me to be honest.