Fever range for infant

Fever (0-12 Months)

Is this your child's symptom?

An abnormal high body temperature
Fever is the only symptom. Your child has a true fever if:
Rectal (bottom), Ear or Forehead temperature: 100.4° F (38.0° C) or higher
Under the arm (armpit) temperature: 99° F (37.2° C) or higher
Caution: Ear temperatures are not accurate before 6 months of age
Caution: Forehead temperatures must be digital. Forehead strips are not accurate.

Causes of Fever

Overview. Almost all fevers are caused by a new infection. Viruses cause 10 times more infections than bacteria. The number of germs that cause an infection are in the hundreds. Only a few common ones will be listed.
Viral Infections. Colds, flu and other viral infections are the most common cause. Fever may be the only symptom for the first 24 hours. The start of viral symptoms (runny nose, cough, loose stools) is often delayed. Roseola is the most extreme example. Fever may be the only symptom for 3 to 5 days. Then a rash appears.
Bacterial Infections. A bladder infection is the most common cause of silent fever in girls.
Vaccine Fever. Fever with most vaccines begins within 12 hours. It lasts 2 to 3 days. This is normal and harmless. It means the vaccine is working.
Newborn Fever (Serious). Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment.
Meningitis (Very Serious). A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Younger children are lethargic or so irritable that they can't be consoled. If not treated early, can suffer brain damage.
Overheated. The fever is usually low grade. Can occur during heat waves or from being overdressed. The temp becomes normal in a few hours after moving to a cooler place. Fever goes away quickly with rest and drinking extra fluids.
Not Due to Teething. Research shows that "getting teeth" does not cause fevers.

Fever and Crying

Fever on its own shouldn't cause much crying.
Frequent crying in a child with fever is caused by pain until proven otherwise.
Hidden causes can be ear infections, kidney infections, sore throats and meningitis.

Normal Temperature Range

Rectal. A reading of 98.6° F (37° C) is just the average rectal temp. A normal low can be 96.8° F (36° C) in the morning. It can change to a high of 100.3° F (37.9° C) late in the day. This is a normal range.

When to Call for Fever (0-12 Months)

Call 911 Now

Not moving
Can't wake up
Severe trouble breathing (struggling for each breath; can barely speak or cry)
Purple or blood-colored spots or dots on skin
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Trouble breathing, but not severe
Great trouble swallowing fluids or spit
Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
Fever over 104° F (40° C)
Shaking chills (shivering) lasting more than 30 minutes
Nonstop crying or cries when touched or moved
Won't move an arm or leg normally
Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Age 3-6 months old with fever
Age 6-12 months old with fever that lasts more than 24 hours. There are no other symptoms (such as cough or diarrhea).
Fever lasts more than 3 days
Fever returns after gone for more than 24 hours
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

You have other questions or concerns

Self Care at Home

Fever with no other symptoms and your child acts mildly ill

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle

Care Advice for Fever

What You Should Know About Fever:
- Having a fever means your child has a new infection.
- It's most likely caused by a virus.
- You may not know the cause of the fever until other symptoms develop. This may take 24 hours.
- For infants more than 3 months old, most fevers are good for sick children. They help the body fight infection.
- Use the ranges below to help put your child's level of fever into perspective:
- 100° - 102° F (37.8° - 39° C) Low grade fever: helpful, good range. Don't treat.
- 102° - 104° F (39 - 40° C) Average fever: helpful. Treat if causes discomfort.
- Over 104° F (40° C) High fever: causes discomfort, but harmless. Always treat.
- Over 106° F (41.1° C) Very high fever: important to bring it down. Rare to go this high.
- Over 108° F (42.3° C) Dangerous fever: fever itself can be harmful.
Treatment for All Fevers - Extra Fluids:
- Fluids alone can lower the fever. Reason: being well hydrated helps the body give off heat through the skin.
- For shivering (or the chills), give your child a blanket. Make them comfortable.
- Offer your child extra water or other fluids by mouth. Cold fluids are better. Until 6 months old, only give extra formula or breastmilk.
- For all children, dress in 1 layer of light weight clothing, unless shivering. Reason: also helps heat loss from the skin.
- For shivering (or the chills), give your child a blanket. Make them comfortable.
- Caution: if a baby under 1 year has a fever, never overdress or bundle up. Reason: Babies can get over-heated more easily than older children.
Fever Medicine:
- Caution: Do not give a baby under 3 months any fever medicine. Most of these babies will need to be seen.
- For fevers 100°-102° F (37.8° - 39°C), fever meds are not needed. Reason: fevers in this range help the body fight the infection. Fevers turn on the body's imune system. Fevers don't cause any discomfort.
Give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil) if over 6 months old.
Goal of treatment: keep the fever at a helpful level. Most often, the fever meds lower the fever by 2° to 3° F (1 - 1. 5° C). They do not bring it down to normal. It takes 1 or 2 hours to see the effect.
Do not use aspirin. Reason: Risk of Reye syndrome, a rare but serious brain disease.
Do not use both acetaminophen and ibuprofen together. Reason: Not needed and a risk of giving too much.
Pain: fever does not cause pain. If your child also has pain, it's from the infection. It may be a sore throat or muscle pain. Treat the pain, if it's more than mild.
Return to Child Care:
- Your child can return to child care after the fever is gone. Your child should feel well enough to join in normal activities.
What to Expect:
- Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C).
- They may last for 2 or 3 days.
- They are not harmful.
Call Your Doctor If:
- Your child looks or acts very sick
- Any serious symptoms occur such as trouble breathing
- Fever goes above 104° F (40° C)
- Any fever occurs if less than 12 weeks old
- Fever without other symptoms lasts more than 24 hours
- Fever lasts more than 3 days (72 hours)
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/11/2022

Last Revised: 09/18/2022

Fevers (for Parents) - Nemours KidsHealth

All kids get a fever from time to time. Usually, a fever isn’t dangerous or bad for kids. It can even be a good thing because it can help the immune system fight infection.

Still, parents might be unsure about how to handle a fever at home and when to call the doctor. Here are some tips.

What Is a Fever?

In general, a fever means the body’s temperature is 100.4°F (38°C) or higher. Different ways of measuring a temperature — rectal, armpit, ear, forehead, mouth — get a slightly different number, so the number that means a child has a fever is a little different too.

What Causes Fevers?

Fevers in kids are usually caused by an infection. A fever helps the body by stimulating the immune system to fight the infection. Doctors also think the higher temperature makes it harder for the germs to grow.

A few other reasons kids can have a fever:

Overdressing: Infants, especially newborns, may get fevers if they're overdressed, wrapped in a blanket, or in a hot environment because they don't regulate their body temperature as well as older kids. But because fevers in newborns can be a sign of a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

Immunizations: Babies and kids sometimes get a mild fever that lasts about a day after getting vaccinated.

A child who is teething might have a slight rise in body temperature, but it's probably not the cause if the temperature is higher than 100°F (37.8°C).

When Is a Fever a Sign of Something Serious?

In most healthy kids who are acting well, a fever isn’t serious.

But a fever can be serious for:

Infants younger than 3 months: If an infant younger than 3 months has a rectal temperature of 100. 4°F (38°C) or higher, call your doctor or go to the emergency department right away.
Kids with some health conditions: If your child has an ongoing health issue, make sure you know if the doctor should be called for fever.

A fever is probably not serious if your child is 3 months or older and:

is still interested in playing
is drinking well
is alert and smiling
has a normal skin color
looks well when their temperature comes down

Don't worry too much about a child with a fever who doesn't want to eat. This is common with infections that cause fever. For kids who still drink and urinate (pee) normally, not eating as much as usual is OK.

What Are the Signs of a Fever?

Kids with a fever might:

feel warm
act differently (they might be fussy or cranky, or quieter than usual)
breathe a little faster or have a faster heart rate than normal
have a headache
have chills or sweating
have red or flushed skin

For any of these signs, take your child’s temperature to know if they really have a fever.

If your child feels warm or is acting unwell, use a digital thermometer to confirm a fever. Different ways of taking the temperature are more accurate than others at measuring the true body temperature.

The best way to take a temperature:

for kids 3 years old and younger: a rectal temperature
for kids 4 or older who can cooperate: an oral temperature (by mouth)
for any age: under the armpit (axillary) and temporal artery (forehead) are easiest but less accurate. Tympanic (in the ear) is OK for kids 6 months and older.

It's a fever when a child's temperature is at or above one of these levels:

rectal (in the bottom), tympanic (in the ear), or temporal artery (across the forehead): 100.4°F (38°C)
oral (in the mouth): 100°F (37.8°C)
axillary (under the arm): 99°F (37.2°C)

How Can I Help My Child Feel Better?

No treatment is needed if a child is still playing and drinking normally and doesn’t have pain.

Treating a fever with medicine isn't needed if a child is still playing and drinking normally and doesn’t have pain. Give medicine only when a fever causes a child discomfort or keeps them from drinking.

While kids have a fever, keep an eye on them, help them to rest, and keep offering fluids to drink. They need to drink a little extra to make up for the fluids they lose from sweating.

Home Care Measures

Medicines

If your child is uncomfortable from a fever or not drinking fluids well, you can give one of these medicines:

acetaminophen (such as Tylenol or a store brand)
or
ibuprofen (such as Advil, Motrin, or a store brand). Do not give to children under 6 months old.

Follow the package directions for how much to give and how often. If you don't know the recommended dose or your child is younger than 2 years old, call the doctor to find out what to use and how much to give.

If your child has any medical problems, check with the doctor to see which medicine to use.
Unless instructed to by a doctor, never give aspirin to a child. Such use is linked to Reye syndrome, a rare but serious illness.

Do not give any medicine for fever to infants younger than 3 months old unless instructed to by a doctor.

Staying Comfortable

If your child has a fever:

Have them wear lightweight clothing and stay covered with a light sheet or blanket. Heavy clothes and blankets can keep the body from cooling, which can make your child uncomfortable.
Keep the room at a comfortable temperature — not too hot or too cold.
Make sure they get plenty of rest. Staying in bed all day isn't necessary, but a sick child should take it easy.
They should stay home from school or childcare until their temperature has been normal for 24 hours.

Lukewarm sponge baths to lower a fever generally are not recommended. In fact, sponge baths can make kids uncomfortable from shivering. Never use rubbing alcohol (it can cause poisoning when absorbed through the skin) or ice packs/cold baths (they can cause chills that can raise body temperature).

Food and Drinks

Offer plenty of fluids to avoid dehydration because fevers make kids lose fluids faster than usual. Oral rehydration solutions (like Pedialyle, Enfalyte, or store brands) are a good choice. You also can give water, soup, ice pops, and flavored gelatin. Avoid drinks with caffeine, including colas and tea, which can make dehydration worse by making kids pee more often.

Let kids eat what they want (in reasonable amounts), but don't force it if they don't feel like eating much.

When Should I Call the Doctor?

The temperature that should trigger a call to the doctor depends on a child's age, the illness, and whether they have other symptoms. You might ask if your doctor has specific guidelines on when to call about a fever.

In general, call the doctor if your child is:

younger than 3 months old with a rectal temperature of 100. 4°F (38°C) or higher
3 months or older with a temperature higher than 102.2°F (39°C)
any age but has a health problem like cancer or sickle cell disease and has a fever

Also call if a child 3 months or older has a fever and:

refuses fluids or seems too ill to drink enough
has lasting diarrhea or repeated vomiting
has any signs of dehydration (peeing less than usual, not having tears when crying, less alert and less active than usual)
has a specific complaint (like a sore throat or earache)
still has a fever after 2–3 days
has a rash
has pain while peeing

Get emergency care if your child shows any of these signs:

crying that won't stop
extreme irritability or fussiness
sluggishness and trouble waking up
a rash or purple spots that look like bruises on the skin (that were not there before your child got sick)
blue lips, tongue, or nails
in an infant, the soft spot on the head seems to be bulging out or sunken in
stiff neck
severe headache
limpness or refusal to move
trouble breathing that doesn't get better when the nose is cleared
leaning forward and drooling
seizure
moderate to severe belly pain

What Else Should I Know?

All kids get fevers, and in most cases they're back to normal within a few days. For older babies and kids, the way they act can be more important than the reading on your thermometer. Everyone gets a little cranky when they have a fever. This is normal and should be expected.

But if you're ever in doubt about what to do or what a fever might mean, or if your child is acting ill in a way that concerns you even with no fever, always call your doctor for advice.

Reviewed by: Melanie L. Pitone, MD

Date reviewed: November 2022

Fever in children

“When children are sick,
There is no peace in anything.
Light goes out on the planet,
and the house freezes,
and nerves along with blood
burn in confusion,
I ask, the health, health
for little guys ”

Love

- this is the biggest the value that parents have. That is why we cannot find a place for ourselves when our children are sick.

Quite often, childhood illnesses are accompanied by fever, which causes certain difficulties for parents. Unfortunately, not everyone knows how to behave properly when a child has a temperature. Trying to alleviate the suffering of their child, parents very often unreasonably use antipyretic drugs, try to dress warmer, cover with a warm blanket and drink hot tea.

What is the right thing to do when a child has a high temperature?

First, let's figure out what temperature is normal.

Body temperature in the axillary region in children of different ages can vary in the range of 35.1-37.4 ^o C. A feature of childhood is body temperature fluctuations during the day by 0.5 ^o C with maximum values in the evening time.

It must be remembered that an increase in temperature is a signal of an inflammatory process in the body, which our body is able to cope with on its own. And if during this period we take antipyretic drugs, then we block the protective reaction of the body and contribute to the development of the disease. Therefore, antipyretic drugs should be taken only when a critical temperature threshold is reached, and in no case on an ongoing basis. In addition, the course of taking these drugs will not allow the doctor to notice the addition of a bacterial infection.

The generally accepted criterion for taking antipyretic drugs is an increase in body temperature above 38.5 ^to C, except for:

Children under 3 months
Children at risk (malformations and diseases of the heart, lungs; damage to the nervous system; febrile convulsions)

In this case, antipyretic drugs are recommended to be taken at a temperature above 38 ^o C, and sometimes even at 37.5 ^o C

Paracetamol and ibuprofen are used to reduce fever in children according to WHO recommendations.

Paracetamol (cefecon, efferalgan, panadol) - has antipyretic, analgesic and anti-inflammatory effects. It is used in children from 1 month of age. A single dose is 10-15 mg/kg, no more than 60 mg/kg per day. It is possible to take the drug 3-4 times a day. The antipyretic effect occurs in 1. 5-2 hours. The drug has various forms of release (rectal suppositories, syrup, tablets), which allows it to be used in children of different ages.

Ibuprofen (ibufen) - has antipyretic, analgesic and moderately anti-inflammatory effect. It is used in children from 3 months of age. A single dose is 5-10 mg/kg, the maximum daily dose is 30 mg/kg. The drug, if necessary, is taken at intervals of 6-8 hours. It has two forms of release - syrup and tablets.

From the age of 3, the combined antipyretic ibuprofen + paracetamol in the form of dispersible tablets (Ibuklin Junior) can be used. The drug reduces fever for a longer period than monotherapy. The daily dose depends on the weight / age of the child and ranges from 3 to 8 tablets for 3-4 doses.

Many parents use analgin and aspirin as antipyretics.

Remember! Taking analgin (metamisole) orally for children under 10 years of age is contraindicated, this drug can cause impaired hematopoiesis. Aspirin (acetylsalicylic acid) is not used in children under 15 years of age with acute respiratory infections, because. promotes damage to the liver and brain. Also, in turn, with fever, children should not be given nimesulide. Therefore, carefully study the composition of drugs, including complex ones, for the content of the active substance in them.

Thus, for a child older than 3 months who do not have risk groups, we reduce the temperature exceeding 38.5 ^about C. To do this, we use one of the antipyretic drugs - paracetamol or ibuprofen in an age dosage, or their combination with 3- x years of age. Do not forget that when the temperature rises, the body needs additional fluids, the child needs a plentiful warm drink. If a feverish child has warm or hot arms and legs, do not try to warm him up, open, undress the child, remove the diaper. If the rise in body temperature is accompanied by pallor of the skin and coldness of the extremities, it is necessary to warm the child, it is necessary to rub the skin of the extremities and torso.

Wiping with warm water and applying ice in the projection of large vessels (in the temple, axillary, popliteal, inguinal regions) also help to fight high fever. All these activities are carried out in parallel with the intake of antipyretic drugs, which contributes to the speedy decrease in body temperature.

If you cannot cope with a high temperature on your own, be sure to seek medical help!

Be healthy!

The material was prepared by the clinical intern of the Department of Polyclinic Pediatrics
GUO BelMAPO Kulesh Daria Petrovna, scientific adviser Ph.D., Associate Professor Ruban A.P.

Hyperthermic syndrome in children: mechanisms of development, features of the course, methods of therapy

Fever is an increase in internal body temperature, which is an organized and coordinated response of the body to illness or any injury. Unlike fever, hyperthermia is a violation of temperature homeostasis resulting from uncontrolled heat production, insufficient heat transfer, or a disorder of hypothalamic thermoregulation [1]. It is known that fever in most cases is a protective-compensatory reaction, due to which the bactericidal activity of blood increases, the activity of leukocytes, phagocytosis, the production of endogenous interferon increases, the intensity of metabolism increases, etc.

It is impossible to determine the exact boundaries of normal body temperature. As with the assessment of many other physiological indicators, not only a wide range of normal values is found, but also a significant crossover between the temperature values in a healthy person and a patient. It is believed that the range of normal rectal temperature ranges from 36.1 to 37.8 ^about C, and oral - from 35.8 to 37.3 ^about C. At the same time, body temperature changes depending on motor activity, circadian rhythm, ambient temperature, age, psycho-emotional state and other factors. In terms of temperature and its curve, fever is subdivided into subfebrile (37.2-38 ° C), low (moderate) febrile (38.1-39°С), high febrile (39.1–41 °С) and hyperthermic — over 41 °С [2].

The duration of the fever can be [3]:

- ephemeral - from several hours to 2 days;

- acute - up to 15 days;

- subacute - up to 45 days;

- chronic - over 45 days.

By the nature of the temperature curve, fever is defined as [4]:

- constant fever - the temperature exceeds 39 ° C with a daily range of less than 1 ° C. This temperature is typical for typhoid and typhus, lobar pneumonia, etc.;

- laxative fever - daily temperature fluctuations exceed 1 ° C and it can fall below 38 ° C, but does not reach normal figures. It is observed in viral diseases, bronchopneumonia;

- intermittent fever - periods of normal and subnormal temperature (1-2 days) alternate with periods of temperature fluctuations with a range of several degrees. Such a fever occurs in malaria, sepsis;

- relapsing fever - high numbers alternate with periods of normal temperature, it occurs with typhus;

- undulating fever - characterized by an undulating course with relatively long periods of rise and fall, such a fever occurs with brucellosis and lymphogranulomatosis;

- debilitating fever - daily fluctuations reach 4-5 ° C, a similar type of fever occurs in tuberculosis and sepsis;

- irregular fever, in which there are no patterns.

It should be noted that fever plays its adaptive role only to certain limits, since it is based on the imbalance between heat production and heat transfer that occurs as a result of an infectious process, stressful situations, intoxications, allergic reactions and other causes. Changes in body temperature have a significant impact on the metabolic activity and functioning of various organs and systems of the body. Thus, an increase in body temperature per degree above 37 ^about C increases the basal metabolic rate by 10-12%, respiratory rate - by 4 breaths, pulse - by 10 beats per minute; accordingly, the need for oxygen, liquid, and caloric supply increases. The respiratory rate and alveolar ventilation increase to a greater extent than the production of carbon dioxide, resulting in the development of respiratory alkalosis, the maximum of which occurs at a temperature of 40-41 ^about C. At a higher temperature, pulmonary ventilation begins to fall catastrophically, tissue metabolism is significantly disturbed, as evidenced by a decrease in the arteriovenous difference in oxygen with sufficient partial pressure in arterial blood. The dissociation curve of oxyhemoglobin shifts to the right, which leads to a decrease in saturation and oxygen content in the blood [5].

Hypocapnia causes a decrease in cerebral blood flow, as a result, the supply of oxygen to the brain worsens, with the likelihood of seizures. Increasing the metabolic rate also requires increased cardiac output. Tachycardia and vasodilation in the systemic circulation contribute to a decrease in venous return and stroke volume of the heart. Systemic arterial pressure decreases, tissue perfusion decreases [6].

With a high demand for oxygen and its reduced delivery, the processes of anaerobic glycolysis are activated, and metabolic acidosis develops. At temperatures above 41 ^o C enzymatic processes in the liver are inactivated, the structure of mitochondria and lysosomes is disturbed. The water-electrolyte metabolism is sharply disturbed, the loss of water and electrolytes increases significantly, and iso- or hypotonic dehydration develops. Thus, hypoxic, metabolic, electrolyte manifestations of hyperthermia, especially in children of the first years of life, disorders of tissue and organ circulation and microcirculation can determine the development of critical conditions, in particular, hyperthermic syndrome [7].

Hyperthermic syndrome is understood as a pathological variant of fever, in which there is a rapid and inadequate increase in body temperature, accompanied by impaired microcirculation, metabolic disorders and progressively increasing dysfunction of vital organs and systems, in particular, damage to the central nervous system. A decisive role in the pathogenesis of hyperthermic syndrome is played by irritation of the hypothalamic region as a center of thermoregulation. There is a decompensation of thermoregulation with a sharp increase in heat production, inadequately reduced heat transfer and the absence of the effect of antipyretic drugs. The ease of occurrence of hyperthermia in children is due to several reasons: a relatively higher level of heat production per 1 kg of body weight than in adults, since the surface of the body in children is larger than the volume of tissues that provide heat production, a greater dependence of body temperature on ambient temperature, underdevelopment of sweating in premature infants children, which limits heat loss through evaporation. The development of fever against the background of acute microcirculatory and metabolic disorders underlying toxicosis (spasm followed by capillary dilatation, arteriovenous shunting, platelet and erythrocyte slugging, increasing metabolic acidosis, hypoxia and hypercapnia, transmineralization, etc.) leads to an aggravation of the pathological process [8 ].

Hyperthermic syndrome is more often observed in children against the background of infectious diseases (flu, pneumonia, sepsis, etc.), infectious-allergic and toxic-allergic processes, hypervitaminosis D, dehydration, as well as due to birth injuries, respiratory distress syndrome, etc. With the development of hyperthermic syndrome in a child, increasing lethargy, adynamia, pallor of the skin with acrocyanosis, chills, refusal to eat and drink are observed. If adequate assistance is not provided, motor and speech excitement appears, hallucinations, clonic-tonic convulsions are possible. The child loses consciousness, breathing becomes frequent, superficial, its pathological variants are possible. At the time of convulsions, asphyxia can occur, leading to death. Often, children with hyperthermic syndrome develop circulatory disorders: a drop in blood pressure, tachycardia, spasm of peripheral vessels, etc. The most dangerous variant of hyperthermic syndrome is malignant hyperthermia, which can be fatal [9].].

Malignant hyperthermia is rare, but is characterized by a rapid increase in temperature to 42 ° C and above, increasing tachycardia, cardiac arrhythmias, muscle rigidity, arterial hypertension, coagulopathy; developing hypocalcemia with hyperkalemia and hyperphosphatemia leads to metabolic acidosis. For the clinical assessment of hyperthermic syndrome, it is necessary to take into account not only the temperature, but also the duration of hyperthermia and the effectiveness of antipyretic therapy. An unfavorable prognostic sign is fever above 40 °C and its duration [10].

Emergency care for hyperthermic syndrome in children at the initial (prehospital) stage [11]

1. According to the recommendations of the World Health Organization, the drugs of choice for emergency care for hyperthermic syndrome are paracetamol, a single dose of 10-15 mg / kg of body weight (daily - 60 mg / kg / day) or ibuprofen - 5-10 mg / kg. Currently, a form of paracetamol for intravenous use - Infulgan, has been created, which has become a safe alternative to the dipyrone solution used in emergency care for both children and adults. Infulgan is available in glass containers of 20, 50 and 100 ml containing 10 mg of paracetamol in 1 ml of solution. For children weighing 10 to 50 kg, Infulgan is administered intravenously at a dose of 15 mg/kg of paracetamol per injection, that is, 1.5 ml/kg. The maximum daily dose should not exceed 60 mg/kg body weight. For adults and children weighing ≥ 50 kg, a single dose is 1000 mg of paracetamol, the maximum daily dose is 4 g. The interval between repeated administration of the drug should be at least 4 hours.

2. If the skin is hyperemic ("red fever"), it is necessary to unfold, undress the child, wipe the skin with a 40 ° alcohol solution or wrap the child in a wet diaper, blowing with a fan is possible; application of a cleansing enema with cool water (approximately room temperature, i. e. 18-20 ° C).

3. If the skin is pale ("pale fever"), before applying physical methods of cooling, it is necessary to prescribe nicotinamide at a dosage of 0.005-0.01 g, with a frequency of taking up to 2-3 times within 24 hours.

Emergency care for hyperthermic syndrome at the hospital stage [12]

1. If antipyretics have already been used (paracetamol, ibuprofen), orally or rectally (in suppositories), intravenous administration of paracetamol (Infulgan) at a dose of 15 mg/kg of paracetamol per injection is indicated - 1.5 ml/kg. The interval between repeated administration of the drug should be at least 4 hours. It should be emphasized that Infulgan is the only antipyretic agent recommended for intravenous administration in childhood. Its advantages: rapid onset of action (15 min), smooth temperature decrease, 100% bioavailability, predictability of plasma concentration, ease of dosing and a variety of formulations create the conditions for its widespread use, especially in emergency care.

2. In order to improve vascular microcirculation and peripheral circulation, increase heat transfer, a solution of papaverine hydrochloride 2% is indicated: up to one year - 0.1-0.2 ml, over 1 year - 0.2 ml / year of life; no-shpa (drotaverine) - 0.1-0.2 ml / year of life, dibazol 1% solution in a volume of 1-2 mg / kg IM or IV, eufillin solution 2.4% - 3-4 mg / kg IV, 2.5% solution of pipolfen - 1-2 mg / kg, 15% solution of xanthinol nicotinate or nicotinic acid solution 1% - 0.1-0.15 ml / year of life.

3. Powerful antihyperthermic action is exerted by glucocorticoid hormones: hydrocortisone 3–5 mg/kg or prednisolone 1–2 mg/kg of body weight. They should be used in severe infectious diseases, suspected adrenal insufficiency and the ineffectiveness of ongoing antipyretic therapy.

4. Continue to apply physical cooling methods:

- cold on the area of the liver, large main vessels;

- hang an ice pack over your head;

- an enema with water, at a temperature approaching room temperature;

- gastric lavage with room temperature water;

- wrapping the baby in a wet diaper.

5. If there is no effect, apply a lytic mixture (a solution of chlorpromazine 2.5% 1 ml in combination with 4 ml of a 0.25% solution of novocaine and 1 ml of a 2.5% solution of pipolfen) at the rate of 0.1 ml / kg of the mixture, or 1 ml of 2.5% chlorpromazine solution in combination with 1 ml of 2.5% pipolfen solution, 1 ml of 1% dibazol solution and 0.25% novocaine solution (add up to 10 ml) at the rate of 0.1-0.15 ml / kg, re-introduce no earlier than 4-5 hours after the first injection. You can also use a 0.25% solution of droperidol 0.1-0.15 ml/kg.

6. With severe anxiety, agitation, convulsions - seduxen in a 0.5% solution and a volume of 0.5 mg / kg parenterally (in / m or in / in), a solution of sodium oxybutyrate 20% concentration in an amount of 100-150 mg / kg in / in.

7. When body temperature drops to subfebrile numbers (ideally - up to 37.5 ° C), it is necessary to stop measures to reduce body temperature, continue treatment of the underlying disease.