People with fever and the following conditions should be sent to hospital for treatment:
(1) Pay attention to children's mental state. If the child has a high fever, but his spirit is not bad, he can still laugh and play after taking the medicine for reducing the fever, which is almost the same as usual, indicating that the child's condition is not serious and he can rest assured at home. If the child is listless, exhausted and indifferent, it means that the condition is serious and he should go to the hospital as soon as possible.
(2) Observe the child's complexion. If the child's face is normal or flushed, you can take care of it at home. If your face is dim, yellow, blue and purple, and your eyes are in a daze, it means that your condition is serious and you have to be sent to the hospital.
(3) Observe whether the child has severe or jet vomiting. If there is a possibility of brain lesions, he should go to the hospital.
(4) Check whether there is a rash on the skin, and if there is, it indicates an infectious disease or drug allergy. Check whether the skin turns purple and cool, if it exists, it means circulatory failure. In both cases, you need to go to the hospital again.
(5) Observe whether the child has abdominal pain and purulent stool, and don't let the rubbed abdominal pain prompt acute abdomen, and purulent stool prompt dysentery. And you have to go to the hospital.
If the child has only a high fever, there is no such complication. Although the fever is slow or repeated, there is no need to worry. He should get patient treatment and care at home, and can take the following measures:
(a) to keep the environment quiet, comfortable and humid, indoor ventilation regularly, adults do not smoke.
(2) Fever is the body's protective response to microbial invasion, which is conducive to enhancing the body's resistance. Therefore, it is not necessary to take antipyretic drugs when the body temperature is lower than 38.5℃, and antipyretic measures are only needed when the body temperature exceeds 38.5℃.
(3) Sick children should not wear too many clothes, cover too thick quilts, and don't "sweat" to avoid affecting heat dissipation and raising body temperature.
(4) Children should be encouraged to drink more boiled water and eat more fruits. If the child's appetite drops after a fever, you can prepare some delicious and digestible meals, choose a time when the child's temperature is not high, or take medicine to reduce the fever, but don't eat too much.
(5) Keep the stool unobstructed.
How to give a baby with a fever a fever?
Baby from small to large, more or less have some symptoms of fever, and some parents are anxious like ants on hot bricks, seeking medical advice everywhere; Some parents just hope that their children will have a fever soon and all the food and things will come. In fact, too much or too little is a burden to children's health.
What causes a fever?
There are many reasons for children's fever, which can be generally divided into the following three categories:
First, external factors:
Children's body temperature is affected by the external environment, such as wearing too many clothes, drinking too little water, and the indoor air is not circulating in hot days.
Second, internal factors:
Illness, cold, tracheitis, pharyngitis or other diseases.
Third, other factors:
Such as vaccination, including measles, cholera, diphtheria, cough, tetanus and other reactions.
Fever is only a symptom of the disease, not the whole thing. Dr. Song Wenju, director of pediatrics, said that doctors are concerned about the influence and progress of the disease itself, but usually parents only see the symptoms of the disease, such as fever, vomiting and cough, and they are flustered. I don't know if a doctor treats a disease, the first thing is to find the cause of the disease and the way to cure it completely, not just to reduce the fever. Therefore, in some cases, the symptoms of fever will continue to show, so as to explore the real internal cause. Therefore, he reminded parents who are eager to love their son not to blindly ask doctors to reduce fever and treat fever symptoms, but to follow the doctor's advice, accurately find out the real cause of fever and prescribe the right medicine.
Fever will not "burn the brain"
When the baby has a fever, the reason why parents will go crazy immediately is nothing more than a traditional idea that the child's fever will burn his brain. Dr. Ding, director of pediatrics, said that high fever itself does not make the brain worse and the intelligence worse. There was such a misunderstanding before, because medical knowledge had not been popularized and the reasons behind high fever had not been distinguished.
In fact, only diseases such as encephalitis and meningitis, in which the brain itself is destroyed by viruses, will damage intelligence or sensory function, instead of burning people silly and deaf with fever. She further stressed that the stability of the baby's body temperature control center is not as good as that of adults, and mild viral infection may lead to a high fever of 40℃. As long as parents know how to deal with fever, the diagnosis of the cause should be given to a professional doctor, so don't worry too much.
According to statistics, no matter what causes the fever, the body temperature rarely exceeds 465438 0℃. If it exceeds this temperature, the possibility of bacterial meningitis or septicemia is high, so be especially vigilant. As for the high temperature limit that brain cells can endure, it may need to reach 465438 0.7℃, so that the protein of cells will deteriorate due to high temperature, causing irreversible damage. This extreme high temperature is rarely accompanied by diseases, and it is only possible to reach such a high temperature by being allergic to anesthesia and malignant fever in clinic.
Director Ding said that the need to reduce fever has been controversial for a long time, because fever itself will not cause harm to children. Scholars who advocate that fever is not necessary believe that fever is a normal immune response and can help white blood cells fight bacteria. Analyzing the mode of fever is helpful to diagnose the cause, but blindly reducing fever will be misleading. However, most doctors and scholars are in favor of moderate fever reduction. Because fever will increase metabolism, leading to internal friction, patients with headache, burnout, rapid heartbeat, very uncomfortable. Infants and young children are prone to dehydration, and fever leads to water evaporation and a vicious circle. There is a high proportion of infantile spasms, so there is no need to let the fever cause harm.
Drug antipyretic method
The use of antipyretics has skills and principles, and only by understanding its principles can we achieve good results. The common antipyretics are aqua, buccal tablets, suppositories and injections, each of which has a different principle of use-
Low water and mild, the most commonly used syrup is paracetamol, such as Xiaoer Meilin syrup and Xiaoer Baifuning drops.
● Aspirin buccal tablets have good antipyretic effect. However, aspirin may cause Raynaud's syndrome, so it should not be used in some periods, such as when the baby has chickenpox or flu.
● Suppositories are drugs stuffed from anus, which are mainly absorbed through rectum and take effect quickly. If the child refuses to take medicine orally, antipyretic suppository is the best choice. When you use it, you'd rather use less, burn it slowly, and don't use it in large quantities. If it is used intensively, it will easily lead to excessive fever, which will not only lead to a sharp drop in body temperature, but also easily lead to baby diarrhea after drugs repeatedly stimulate the anus.
Injection is the most unsafe antipyretic and is generally not recommended when it is not necessary.
pay attention to
It is best not to use different antipyretics together. If the dosage is not well controlled, there will be hidden dangers. Not to mention, in order to strengthen the antipyretic effect, give the baby several antipyretics or increase the dose. You should know that one of the toxic reactions of antipyretics is to raise the body temperature again.
Physical cooling method
Physical cooling is suitable for children with high fever and good circulation. Its characteristics are simple method and few adverse reactions.
● Warm water bath
Suitable for babies with high fever. The water temperature should be slightly lower than the baby's skin temperature (that is, 32 C-34 C). After the skin is stimulated by cold, the capillaries can contract and then expand, thus achieving the effect of cooling down. When taking a bath, you can also use massage to stimulate passive expansion of blood vessels and promote heat dissipation. Pay attention to uniform force when taking a bath, and gently massage a few times, which can also promote vasodilation. Rub it for a while in places rich in blood vessels such as armpit and groin, which will help to dissipate heat. Rub the limbs and back for 3-5 minutes. After taking a warm bath, wrap the baby with a big towel, let the baby lie down comfortably, and give the baby plenty of warm water.
● Alcohol bath
Pay attention to the concentration of alcohol when rubbing bath with alcohol, generally 30%-50% concentration is appropriate. Alcohol should not be too cold, and the temperature should be 32℃-35℃. After soaking in gauze or towel alcohol, wipe it regularly. It usually starts from the child's neck and rubs from top to bottom along the outside of the upper arm to the back of the hand. Then apply it to the palm along the inner side of the upper arm through the armpit. After wiping the upper limbs, try to wipe your back from below the neck, and gently massage and pat your back with your other hand when taking a bath to promote blood circulation. Finally, wipe the lower limbs from the iliac region in the same way as wiping the upper limbs. Wipe all parts for about 3 minutes. When wiping armpits, elbows, palms, groins, soles and other parts, the stay time should be slightly longer to improve the heat dissipation effect.
Baby's skin is delicate. Take a bath lightly. Don't use too much force to avoid damaging the skin. In the process of rubbing with alcohol, you should pay attention to keeping your baby warm, and there should be no more exposed parts of your body. Cover the wiped parts in time. If you find that your baby is shivering and pale when taking a bath, you should stop taking a bath, cover your clothes to keep warm, and seek medical treatment in time. Alcohol rubbing bath is not suitable for infants and weak children.
● Cold compress on the head
Cold compress on the head is suitable for babies with fever all over the body, especially for babies with low temperature. Wet the towel with cold water and apply it to the baby's forehead, changing it every 5- 10 minutes. You can also fill a water bag with cold water and put it under your brain.
● Cold saline enema
Cold brine soup has obvious cooling effect, but it is not suitable for family operation.
remind
1, it is best to put an ice pack on the child's head before taking a bath, which not only helps to cool down, but also prevents congestion caused by contraction of epidermal blood vessels during taking a bath.
2. The chest, abdomen and back neck are very sensitive to stimulation, which can cause adverse reactions such as reflex bradycardia and diarrhea. It is not advisable to take a bath with warm water or alcohol.
3. Children with rashes should not use warm water to cool down.
Children with fever should be careful when using antibiotics.
At present, there are still many wrong views on the clinical treatment of many common childhood diseases. Recently, the American Academy of Pediatrics and the Centers for Disease Control (CDC) issued guidelines to distinguish between viral infection and bacterial infection, and recommended some new ideas for the treatment of common pediatric diseases.
The use of antibiotics should have clinical indications. In the new thinking of pediatric treatment, the clinical application of antibiotics is very cautious. For ear canal infection, children under 2 years old should be treated immediately when they show signs of infection; But for children over 2 years old, doctors should try their best to obtain accurate clinical evidence of the cause of infection before prescribing antibiotics.
Generally speaking, children with bacterial infection will have symptoms such as exudation, fever, pain and red ears. Just because you feel unwell or have other symptoms doesn't mean it must be a bacterial infection. If it is difficult to determine the type of infection, experts advise doctors to wait and observe while treating pain.
For severe sore throat, the CDC suggested that doctors should always check the streptococcus culture of throat extract, and antibiotics should not be used before the results come out. Bronchitis is mainly an infection caused by virus. For bronchitis, the index recommended by CDC is that the suspected pneumonia or cough lasts 10 to 14 days without improvement.
Doctors pointed out that children who have recently taken antibiotics and are now infected by other pathogens are three to nine times more likely to develop drug-resistant infections than children who have not used antibiotics.
Fever should be aimed at the comfort of children. Dr. Jeffrey. Brown, director of pediatrics department of new york United Hospital Medical Center, said: "Only exogenous children have fever, such as heatstroke caused by being locked in a carriage on a hot day, which is related to brain injury. Endogenous fever generally does not cause brain damage. "
Dr. Brown pointed out that relevant studies have shown that over-treatment of fever can not prevent convulsions in children, and this convulsion has nothing to do with brain damage and poor learning ability. But for babies under six months old, fever may mean serious problems, and parents should take their babies to see a doctor immediately.
Dr RichardGorman, director of the American Academy of Pediatrics' Drug Committee, pointed out that the treatment of fever should be strictly limited to the comfort of children. But what is often seen in clinic is that children are comfortable and doctors are overtreatment. He believes that if children's body temperature reaches 38.8 degrees Celsius, but they lie comfortably on the sofa, there is no need to treat their fever. If the child shows pain, irritability and irritability, then the doctor recommends treatment when the body temperature exceeds 38.3 degrees Celsius. Many studies have shown that untreated low-grade fever may actually help children to eliminate infection more quickly. Elevated body temperature is a part of the body's defense mechanism, which makes the body a host that is not conducive to the survival of viruses or bacteria.