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Caring for a Child with a Fever
What is normal body temperature?
Normal body temperature is around 37° C (98.6° F). Body temperature varies during the day. The lowest body temperature occurs in the early morning hours (2 a.m. to 4 a.m.) and the highest temperature occurs in the late afternoon. Body temperature may also increase as a result of overdressing or strenuous exercise, especially in hot weather.

What is a fever?
A fever is when the body temperature is 38° C (100° F) or higher. Fever means that the body temperature is higher than normal. Fever often means your child has an infection, but other conditions can also cause fever without any infection. Fever is not caused by teething. Infants with serious infections might have below normal temperatures rather than a fever. If a child has a fever over 38° C (100° F) it usually means he has an infection. Fever may help your child fight an illness. Fever may occur after an infant or child has an immunization. In general, the child’s behaviour tells more about the severity of the illness than the degree of the fever. If a child feels warm or feverish, it is more important to observe the behaviour of the child than to take the child’s temperature.

How do you know if a young child has a fever?
1. Observe the child.
A young child with a fever will often appear ill. The child may:
• look flushed or pale
• feel hot or cool to the touch
• be fussy or groggy
• have “goose bumps,” shivers
or tremors
• sweat and/or
• be thirsty

2. Take the child’s temperature. You can tell if your child has a fever by taking the child’s temperature with a thermometer.

What is the best way to take a temperature?
The safest way to take a temperature is in the centre of the armpit or axilla, with a digital thermometer. This is an easy way to take an infant or a child’s temperature. If the child is over two years of age, an ear thermometer can be used.

The ________ Pediatric Society does not recommend using mercury thermometers. Accidental exposure to this toxic substance can occur if the thermometer breaks.

Taking the temperature in the mouth (oral) is unsafe because a young child can bite and break the thermometer, especially a glass thermometer. Also, the reading can be wrong because it is hard to keep a thermometer under the child’s tongue.

IIMPORTANT!!
If your baby is under six months old, call Health Links-Info __________, your public health nurse or your doctor/midwife as soon as you realize that your baby has a fever of 38° C (100° F) or higher. If your child is over six months old, call Health Links-Info __________, your public health nurse or your doctor if your child:
• has a fever higher than 39° C (102° F)
• is excessively cranky, fussy or irritable
• is excessively sleepy, lethargic or unresponsive
• is persistently wheezing or coughing
• is vomiting or has diarrhea
• has a rash, stiff neck, earache, headache, sore throat, or any other signs of illness that worry you
• seems otherwise well, is drinking enough fluids but the fever lasts more than 48 hours

Do not take the temperature in the rectum (bum). This can be dangerous and upsetting to the child.

Fever strips and pacifier thermometers are not recommended because they do not give accurate temperature readings.

How do you take a temperature in the ear?
Follow the manufacturer’s instructions carefully. • Use a clean probe tip each time.
• Gently tug on the ear, pulling it back. This will help straighten the ear canal, and make a clear path inside the ear to the ear drum.
• Gently insert the thermometer until the ear canal is fully sealed off.
• Squeeze and hold down the button for one second.
• Remove the digital thermometer and read the temperature.

How do you take a temperature in the armpit?
This method is usually used to check for a fever in newborns and young children.
• Use a digital thermometer.
• Clean the thermometer with cool, soapy water and rinse.
• Place the tip of the thermometer in the centre of the armpit.
• Make sure your child’s arm is tucked snugly against his/her body.
• Leave the thermometer in place for about a minute, or as long as the package directions state for underarm temperatures.
• Remove the digital thermometer and read the temperature.
• Clean the thermometer.

For a young child or infant, it is easier to take the child’s temperature if you hold him/her in a cradle hold. If your child is older, the child can sit on your lap, with one arm behind your back. A quiet activity such as breastfeeding, or singing or telling a story to your child may help keep the child still.

What should you do if your child has a fever?
Contact a qualified health care professional.

When your child has a fever, medication is not always needed to reduce the temperature.
In fact, the best reason for giving your child medication is not to reduce fever but to relieve the associated aches and pains.
• If your child has a fever, make sure he/she is comfortable.
• Offer plenty of fluids to drink such as water, watered-down apple juice, “flat” soft drinks or popsicles. If your child is breastfeeding, offer more frequent breastfeeding opportunities.
• Remove extra blankets and clothing so heat can leave your child’s body. This helps lower the body temperature. Cover only with a sheet.
• Do not take off all your child’s clothes because your child may become too cold and start to shiver. Shivering produces more body heat, causing the temperature to rise again. Keep your child in light clothing: diapers or panties and a light shirt. This allows the extra heat to escape from your child’s body.
• Wash or bathe your child with tepid (lukewarm) water to help reduce the fever. Check your child’s temperature 30 minutes afterwards.
• If your child starts to shiver, stop the washing or bathing, dry and dress your child, and cover with a dry sheet.
• NEVER use alcohol or cold water to sponge or bathe your child. Alcohol is a poison and can be absorbed through your child’s skin.
• Feed your child if he/she is hungry. Many children with a fever will not feel hungry.

Medication:
Acetaminophen is the best drug for lowering fever in children and teenagers.
There are many brands of acetaminophen that come in different forms such as drops, liquid, syrup, elixir, tablets and capsules.

The form of medication and dosage depends on your child’s weight and age. Read product labels carefully for ingredients, dosage and frequency. For advice, contact Health Links-Info __________, your pharmacist, your public health nurse or your physician/midwife.

The fever temperature usually comes down in one-and-a-half to two hours after taking acetaminophen. Often it rises again and then the medication may have to be repeated. It is important not to exceed the recommended doses in 24 hours.

Acetylsalicylic acid (ASA) is not recommended because it has been associated with a rare and often fatal disease called Reye’s Syndrome.
If you have other questions, please call Health Links-Info _________, your local public health nurse, or your physician/midwife.