Toddler Fever - Paracetamol Not Working

[BoopityBoop]

Toddler (2) has had fever of 39+, yesterday evening to this morning we couldn't get it below 40. DC is clearly uncomfortable and mostly unlike their usual self (aside from 30 mins yesterday and a short period today playing before going back to wanting to be held and grizzly).

We're alternating paracetamol and ibuprofen. I've noticed the paracetamol doesn't seem to get it down, sometimes the temperature seemed back up to where it was before it began or higher than that, before the ibuprofen is due.

I've monitored it hourly on the paracetamol and it's because it's not doing anything at all for the fever.

We've tried:
Cooler room - rads turned off in that room
No blanket
Cool clothing (just a light vest or nappy)
Cool foods and drink although DC isn't eating or drinking much.

Any advice?

It sounds as if you're doing as much as you can be (check you are giving the right doses) and the illness needs to run its course.

Probably time to talk to a Dr. Temperatures that don't respond to paracetamol or ibuprofen should be checked out. I know when my daughter had a 40+oC fever her gp gave us 2h to get it down or we would have been sent to down to the hospital. I'd call your GP before they close for advice.

Have they got any other symptoms?

Kawasaki disease has the main symptom of a fever that wont reduce - how long has it been going on for?

It takes a good hour for paracetamol to lower my DD's temperature. Nurofen is much more quick acting and effective. If her fevers are staying above 38.5 with these meds I'd want to see a GP today.

Yes, 7.5ml paracetamol and 5ml ibuprofen, which is in line with the box instructions.

It seems like a bad case of a viral infection to us. Symptoms are: fever, coughing, sneezing, congestion, a red rash (more pimply but a bit clustered on the chest, back, legs and face). It could be more heat or a viral rash as it doesn't look like anything we're concerned about at the mom. Difficulty toileting (number 2), has been going but complained about tummy pain. DC complained their armpits hurt so I think it must be lymph nodes, especially as I can see the ones in the neck are raised.

It's just the paracetamol not working. The ibuprofen does work (although it won't bring it down completely). Obviously we can only give 3 doses in 24 hours though.

@28andgreat Sorry, missed your last bit. It's day 3 today. I think DC was ill on Friday though, looked awful and went to sleep quite early after coming back from childcare.

Day 3 of a fever not controlled adequately by paracetamol or ibuprofen warrants the GP. It could be bacterial and need antibiotics.
My daughter has only had antibiotics twice and both occasions the fever didn't respond properly to meds and wasn't improving by days 3-5.

Time to see a doctor. We had a fever that wasn’t controlled by paracetamol and contained by nurofen for a few hours only. Consistently at 40 degrees. Doctors insisted viral but I felt it was something more serious. DC ended up admitted for suspected sepsis. Please get them checked.

Call 111

I’m pretty blase about illnesses but I would be calling 111. How are they behaving?

Please seek care. My DD 3.5years had similar last week but was vomiting also and we ended up in hospital (IV fluids and anti sickness) Paeds wards was full of similar ages kids with similar symptoms as there’s a very nasty virus that calpol etc just isn’t sorting. The doctors warned us that little ones rally and compensate then go downhill very fast so it’s much better to ‘catch them’ before.

DC has been staring at our TV, trying to get comfy on me and getting irritated. Little slivers of DCs personality every now and then, last was running into DC1's room as a joke and back again to get back on my lap. DC will talk every now and then too, mainly to tell DC1 and DH to go away.

With DCs behaviour this evening, we've been torn about waiting until the morning for advice.

I'd say that's exactly it @Silverbirchtable, the ibuprofen will take it down slightly but the temperature hasn't been back down to normal. An hour and a half ago when the paracetamol was given it was 38.7, it's now 39.4. Did your DC have any other symptoms for suspected sepsis?

You need to see a doctor. When we’ve had paracetamol not being as effective, it was a nasty case of tonsillitis and my DC never complained of a sore throat.

I think you need to go to an and e tonight, just to be safe. Especially as you mention the rash and the meds not getting the temp down.

Docs have always said they'd rather send a not very sick child home than miss a properly sick one. If you see what I mean.

Trust your instincts, get it checked out if it doesn't feel right. The times my DC have needed docs/hospital etc I just knew.

@BoopityBoop started as a cold, he went up and down. Would play then be really tired. V little appetite, and as he got worse he stopped drinking. He was oddly chatty at times which made the doctors say he was active even though I knew it was odd for him to be that wired, he’s normally laidback. He was about 20 months at this stage so hard to get info on what hurt etc. We went to A&E three times by the time he finally got admitted.I just knew he wasn’t right but can’t give more specific symptoms aside from fever that wouldn’t respond to meds, no appetite and generally really quite unwell. I demanded a CRP test in the end which they did to shut me up, and when the result arrived, quiet panic from staff and he was put on IV antibiotics. Chest x-Ray showed a chest infection in the end. He was really quite poorly and it worries me what might have been if I hadn’t pushed. I really would get your DC checked asap with a 3-4 day fever. X

I've spoken to 111 and they've suggested the pharmacy in the morning 🤷‍♀️

They were very focused on what our main issue was: rash or cold symptoms besides the fever. I said the cold symptoms are not concerning in themselves, our issue is behaviour and fever which is difficult to manage. They wanted a secondary concern out of the two so I said rash, I guess.

Unfortunately we don't have an out of hours service unless through 111 so apart from A&E that was our only option tonight.

That's ridiculous from 111, what can a pharmacy do that's hasn't already been tried?
If my child was a sick as you describe yours to be, with a temp of 40+ that wouldn't come down with calpol and a rash of any sort, I would be camping out in A&E until they sorted it.
I would strongly advise A&E, better safe than sorry surely??

I’d ignore that advice tbh, I agree with poster above. 111 is essentially an algorithm - and I’m surprised 4 days of fever/40 degrees didn’t trigger it but the pharmacy will prob just say to see a GP. I’d be heading to A&E based on the symptoms you’ve listed. I hope your DC improves soon.

I'd be going to A&E
111 are shite, they never called me back about my DDs temp a few days ago! That's a really blase response from them

Don't be afraid to call 111 back and ask to speak to a clinician OP. It does sound like your little one should be checked over in person. At that age doctors are always happy to check. Don't let 111 fob you off!

Another one saying A&E, even if just for peace of mind. I ummed and ahhed over taking my toddler for similar and we ended up going, glad we did as she ended up needing to stay in hospital for 4 days with a nasty case of strep a. Better safe than sorry.

I am a little shocked by the response from 111, it did seem like they weren't seeing past the script. But I'm assuming because whilst DC was ill on Friday, the fever was only picked up on Saturday by us so it'd be counted from then. And that the temperature has managed to drop below 39 this evening for a short period? The most frustrating part is that it hasn't stayed below that for very long.

DC fell asleep not long after the call but I've since managed to wake just enough to take the next dose of ibuprofen. The fever is currently 39.7 and so I'm hoping that will bring it down at least slightly whilst DC gets some sleep and if it's still high, take DC in.

I was just looking at a separate face rash DC woke up with Friday which I thought was a dribble rash, it was there before the other one came up but I do wonder about strep a.

Thank you for your replies as well, I did feel stupid having spoken to 111 and being told it's nothing more than a trip to the pharmacy required. We were starting to doubt ourselves.

I'm really surprised they didn't take it more seriously too, a temp like that in a 2 year old should always be checked out. I don't know if you have a local hospital but ours has at the very least an advanced nurse practitioner who can prescribe on duty overnight and 111 can issue appointments, even in the middle of the night for little ones! (They don't advertise this though!) Hopefully you have something like that near you!

I’m very surprised that you were told that by 111.
Call your GP in the morning. Alternatively, do you have a walk in centre nearby?