A high fever in a child or hyperthermia is a common occurrence. If you have already learned the happiness of becoming a parent or are just getting ready, sooner or later you will face this problem. In this article, I will talk about the algorithm for providing emergency care for hyperthermia in children. I will focus on the child's age, because there are differences in helping children 1 - 2 years old, 3 and 6 years old. After reading the article, the high temperature will not catch you by surprise and will not cause panic, you will calmly bring it down at home and alleviate the suffering of your child.

What is high body temperature or hyperthermia

I want to say right away that an increase in temperature is a pathophysiological process, as a result of which the body mobilizes defense processes, activates the immune system to fight viruses and bacteria. This increase is necessary, therefore you have repeatedly heard that it is undesirable to bring down the temperature to 38 degrees.

Types of body temperature in children

These definitions apply not only to children, but also to adults:

1. subnormal - 35-36 ° C. It usually occurs in elderly people or severely weakened children, a prognostically unfavorable sign;
2. normal - 36-37 ° C. Although in many Western countries, including America, temperatures up to 37.5 are considered normal;
3. subfebrile - 37-38 ° C. This is the temperature that in most cases does not need to be brought down. Below I will tell you in what cases it is necessary to reduce this temperature in a child;
4. increased - 38-39 ° C;
5. high - 39-40 ° С;
6. excessively high - above 40 ° C.

What is "white" and "red" fever in children

Depending on the mechanisms of occurrence and course, the increased temperature (fever) in children is conventionally divided into red and white. The tactics of treating the baby depend on the type of fever. With red fever, the child's skin is red, the limbs (arms and legs) are warm, the ears and nose are red-pink and also warm to the touch. The general condition of the kinder is satisfactory, he is active, plays, eats, despite the fact that the thermometer shows disappointing 38.5-39.0 degrees.

With "white" - cold and pale extremities (hands and feet as cold as ice) are noted, despite the high temperature. The skin of the face, nose, ears is also white with a bluish tint. This occurs due to spasms of peripheral vessels, as a result of which normal heat transfer does not occur. The general condition of the child is moderate or severe. He is lethargic, pale, he is cold, does not want to do anything. This high temperature option is more dangerous. I will write below what parents should do with such a fever. ...

Emergency care for hyperthermia in children - an algorithm for providing at home

If your child is several months old, 1, 2, 3 years old, 6 years old or older from birth, and you do not know what to do at high temperature, then this algorithm will help bring down the temperature without medication.

How to bring down a temperature of 39 without medication

If your baby's skin is pink, hands, feet, and nose are warm or hot. If the kinder is active, and the thermometer has an awful 39, then these rules will help you bring down the temperature yourself at home.

With the correct implementation of the above algorithm, the child's temperature decreases by 1 - 1.5 degrees, providing a comfortable 37 - 37.5 ° C, which is needed to activate the immune system. These rules cannot be ignored. They are more difficult to fulfill than just giving an antipyretic agent, but medicines are medicines, they have certain toxic effects on organs. Plus, fever-knocking drugs won't work with dehydration when the body is low on water.

All these actions can be performed only with the so-called "red fever".

Remember, if the temperature lasts more than 3 days, you need to see a doctor (pediatrician, family doctor). If you are not yet a year old, you must contact immediately after the temperature rises.

If your baby has any congenital malformations or concomitant diseases, previously had febrile seizures, head injuries, then in this case - only call an ambulance or a doctor at home.

White fever in a child - what to do

If your child has a high temperature of 39 - 40 ° C, and at the same time his hands and feet are cold as ice, he himself is pale, then in this situation it is necessary to perform the following actions and call an ambulance or seek help from a doctor (parents must understand that "white fever" is very often manifested in severe viral or bacterial infections):

1. give the child hot tea. Hot tea will warm the child and relieve peripheral vasospasm;
2. put a bottle of warm water on your feet. In this situation, the baby needs to warm up his arms and legs so that the blood vessels expand and begin to give off heat. Put on socks and cover with a blanket;
3. give one tablet of no-shpa (drotaverine) or papaverine. Antispasmodics are needed to relieve the same vasospasm;
4. give antipyretics (ibuprofen or paracetamol). Read about the calculation of the dosage of paracetamol and ibuprofen by the weight of the child in a separate article on the drug treatment of high fever in children;
5. wait for the doctor to decide on further treatment.

All these actions allow you to translate "white" fever into "red" or, as it is also called, "pink". If you managed to do this, the above is a list of actions for pink (red) fever.

Do you want to know how to bring down the temperature of 39 in a child at home? Such knowledge will be useful to parents, because effective methods at home are the only thing that helps when there is no medicine and the opportunity to go to a doctor.

It is important to know that it is possible to bring down the temperature by 39 with safe home remedies. When babies have a fever, they experience seizures, and it is impossible to cope without the intervention of specialists. In order to avoid serious consequences, it is important to turn to proven methods that allow you to quickly eliminate the problem, move on to combating the causes of the occurrence.

Microclimate creation

The first step is to create an ideal microclimate. This is important when babies have airway swelling. The room should be cool, the room should be ventilated. Ideal temperatures are from 18 to 20 ° C, humidity is within 50-60%.

Important!In no case should you use warm blankets for wrapping at high temperatures. This leads to overheating, heatstroke.

Fever is not always accompanied by a pronounced chill. If this is your case, go for light clothing. A sick baby is not covered with warm blankets.

Drinking regime

The body regulates temperature with fluid that is excreted through the skin. The high temperature is accompanied by dehydration.

Trying to figure out how to bring down the temperature of 39 in a child, they pay attention to abundant drinking. The baby is applied to the breast or watered clean through a baby bottle.

Older children consume warm (but not hot) teas. An effective drink is cranberry juice. An important role is played by the amount of liquid drunk, the frequency of drinking.

Do not give babies a large amount of liquid at a time, otherwise vomiting will occur, which will worsen the patient's condition.

The drink is divided into several portions.

Children are given to drink fractionally and often. The ideal frequency is a couple of small spoons every ten minutes.
After an increase in the drinking regime and a drop in temperature to 38 ° C, for adult children, tea is prepared with the addition of cranberries or lemon. It is a safe method to stabilize body temperature in babies.

Physical cooling

The method is widespread and effective, but it requires caution. They resort to physical cooling when the elevated temperature is not accompanied by vascular spasms. Cramps are indicated by cold, pale limbs.

In the absence of spasms, the child is wiped with warm or slightly cool water. Compresses are made on the forehead. A composition is prepared with the addition of 9% vinegar. Three tablespoons are diluted with 0.5 liters of warm water. Wipe the folds at the elbows and knees, treat the feet and folds of skin near the groin, where the large lymph nodes are located.

The use of ice compresses or cold water rubdowns is discouraged. This will aggravate the patient's condition, make him tremble, suffer from swelling of the respiratory tract. Many parents use cold water douches.

Cold bathing is a risky method. According to the laws of physics, it is possible to lower the temperature, increase the heat transfer, but the heat will decrease on the surface, and the problem will not disappear.

In no case should you rub with vodka, as adults do to lower the temperature. Alcohol quickly evaporates from the skin and “draws in” heat, allowing the temperature to stabilize. For a child, manipulation is risky.

Children's skin will quickly absorb some of the alcohol in any form. The components are absorbed into the bloodstream and in small quantities are dangerous for a young and weakened organism. Rubdowns often lead to poisoning.

Experts say that dry alcohol is absorbed faster, which means that the body is poisoned faster.

Antipyretic drugs

Simple antipyretics are safe for children. Helper in the fight against fever - paracetamol. They are used in several forms:

• powders for tea;
• tablets in different dosages;
• candles.

At a temperature of 39 ° C, it will not work to bring down the temperature for a long time with paracetamol. But for 3-4 hours it is realistic, if you correctly calculate the dose of the active substance. Calculate the dosage as follows:

• 15 milligrams of paracetamol per kilogram of baby's weight for a single use;
• children over two years old increase the dosage to 20 ml per kilogram of weight. This will make the heat-reducing effect lasting, allowing you to wait for the doctor.

They resort to paracetamol when mild remedies are useless. Doctors recommend not to experiment with the use of medicines on your own.

Important! Refuse to use active substances belonging to the group of anti-inflammatory nonsteroidal drugs. Acetylsalicylic acid and all drugs associated with the development of side effects are blacklisted.

Raspberry tea

The drink contains acetylsalicylic acid, but unlike dangerous ones, it is in safe doses in tea. Raspberry tea is considered an effective remedy for high temperatures. It belongs to diaphoretic, not diuretic (dangerous at high temperatures) means. Making tea with raspberries on the basis of black leaf tea, relieve swelling of the respiratory tract.

Tea is contraindicated for convulsions. The drink is not recommended for children under one year old - it causes allergic reactions.

Herbal decoction

At home, medicinal herbs help to save a child from a high temperature:

• inflorescences of linden;
• leaves of mother and stepmother;
• dog-rose fruit.

It is important to know that plants contain allergens to which the body of young children is sensitive. Give decoctions to older children, preferably as an additional tool.

Milk and honey

It is forbidden to give honey and milk to children under one year old. It is ideal to use the product only for older children, provided there is no allergic reaction to the components. Boil milk beforehand, dilute honey after cooling (dissolve in warm milk), otherwise honey will lose its beneficial properties.

Grandma's secret

A proven and effective method. It turns out that the high temperature is knocked down with potatoes. Take 2 small potatoes, wash and rub with a peel on a coarse grater. Apply to the wrist, ankles, elbows, forehead. Rewind with gauze or bandage and leave.

After 40 minutes, the temperature will drop. The procedure is repeated.

Responsible and caring parents should understand that using pharmacy remedies for fever is not always better than helping without medication.

What temperature should be reduced?

If the temperature does not exceed 38 ° C, and the child tolerates it quite normally, then antipyretics should not be given, because at elevated temperatures the body fights infection more effectively, so it should not be brought down. With the exception of children who have neurological diseases, or the child, against a background of fever, has deteriorated, chills, muscle pains, pallor of the skin are noted, then antipyretic drugs should be taken immediately.

If the temperature rises above 38 ° C, you should give the child antipyretic drugs that you have taken before, or on the recommendation of a doctor (Children's Panadol, Efferalgan, Nurofen). As a rule, newborns use antipyretic in suppositories, older children are given the drug in the form of a syrup. Do not use aspirin under any circumstances! Aspirin with a viral infection (in children under 12 years old) can cause a dangerous complication - Reye's syndrome.

How to lower the temperature?

• The first to undress the child, if the child is small, remove the diaper.
• Rub with a damp cloth (its temperature should be slightly higher than room temperature) or place the child under a warm (not hot) shower, gradually lowering the water temperature to cool.
• Provide rest, put to bed.
• Drink abundantly with sweet tea, fruit drink, you can give chamomile tea.
• In case of chills, warm up (warm blanket, hot tea), but you cannot keep wrapped up for a long time so as not to overheat.
• You can fan your child by blowing the wind if the temperature is above 39 ° C.
• Give antipyretics at a temperature: above 38.0 ° C in children under 3 months, above 39.0 ° C in healthy children older than 3 months, in case of chills, headaches or muscle pain at a lower temperature, above 38-38.5 ° C with a history of febrile seizures, above 38.5 ° C in severe concomitant diseases.
• You should not wrap your child up at 40 ° C.
• At temperatures above 40, .2 ° C, call emergency help.

Convulsions

If your child has seizures, they usually go away on their own after 3-5 minutes, so stay calm. Status epilepticus is dangerous - these are prolonged convulsions for more than 10-15 minutes, which requires immediate medical attention.

Do not mechanically restrain the cramps - this can intensify them, do not insert objects (spoon, fork) into the oral cavity to fix the tongue - this can lead to fractures of the teeth, swallowing these objects.

First aid procedure:

• Place the child in a safe place, on a flat surface where there is no danger of injury, remove objects with sharp and protruding edges from the environment.
• Unbutton the jacket, or remove it altogether to facilitate breathing.
• Place something soft or flat under your head.
• Turn the baby on its side to prevent choking due to vomiting or falling tongue, stay close to the baby.
• If the seizure occurs for the first time, or lasts more than 5 minutes, or has recurred, call emergency help.

Choosing a medicine

When choosing the form of the medicine (liquid medicine, syrup, chewable tablets, suppositories), it should be borne in mind that drugs in solution or syrup act in 20-30 minutes, in candles - after 30-45 minutes, but their effect is longer. Candles can be used in a situation where the child vomits while taking fluids or refuses to drink the medicine. Suppositories are best used after a child has had a bowel movement, they are convenient to insert at night.

The general condition of the patient and the presence of concomitant pathology also play a role in deciding whether to lower the temperature. In cases where the temperature does not exceed 38.5 degrees in adults and 38 degrees in children, it is recommended to carry out measures aimed at reducing it only in certain cases, such as:

• child's age up to three months;
• a history of seizures with hyperthermia;
• existing severe heart and lung diseases, accompanied by the development of failure;
• the presence of diseases of the central nervous system.

Urgent measures for pink hyperthermia

The presence of high body temperature, causing it to rise to 40 degrees, necessitates active measures to reduce it. Since a further increase in temperature may already be unsafe for the body, measures to reduce it should be carried out for all patients, without exception.

First aid at a high temperature consists of physical activities and taking medications.

The use of non-drug methods is quite effective, and can in no way worsen the patient's condition, in contrast to drugs that have a wide range of side effects. This is why physical action to lower the temperature is so important. This is especially true for children with their imperfect thermoregulation and very dependent on external conditions.

In most cases, a feverish child is lethargic, capricious. Its skin is pink, moist, hot to the touch. Tachycardia corresponding to temperature indicators is noted. However, in rare cases, more often in premature babies, there is a condition characterized by a sharp blanching of the skin, up to cyanosis. At the same time, the child is sharply apathetic or agitated.

Convulsions may occur. Despite the high fever, his hands and feet feel cold when touched. In this regard, first aid at a high temperature in a child may differ.

With pink hyperthermia in a child, the following measures are necessary:

1. The temperature regime in the bedroom should be 19-20 degrees;
2. Additional wrapping of the child is not required;
3. It is necessary to free him from disposable diapers that impede heat transfer;
4. Shows rubbing the skin with cool water;
5. Clothing should consist of cotton pajamas that absorb sweat most effectively.

In addition to performing these physical activities aimed at, first aid at temperatures reaching 39-40 degrees includes the use of antipyretics prescribed by a doctor in dosages appropriate for age. In children, these are paracetamol, ibuprofen and their derivatives. These medicines can be used in any form convenient in this case: tablets, syrup, rectal suppositories.

In cases where the condition remains stable for three days, it is necessary to consult a doctor to clarify the diagnosis.

Preservation of high temperature indicators for five days is a reason for the delivery of tests and the need for additional examinations.

Urgent measures for white hyperthermia

The high temperature caused by the development of white hyperthermia requires slightly different approaches. First aid for hyperthermia in this case looks like this:

1. It is necessary to warm your hands and feet using a heating pad, mittens, socks or rubbing them with a soft cloth until they get warm;
2. Drinking plenty of fluids is also essential. In addition to lowering the temperature, it promotes the active elimination of pathogens.

With regard to the use of antipyretic drugs, they must also be used, even at lower temperatures. These preparations can also be in any convenient form. Since the vascular component is involved in the development of white hyperthermia, which provides spasm of peripheral vessels, it is also necessary to take antispasmodics, such as papaverine, nikoshpan.

The action of these drugs begins in 20 minutes, reaching maximum concentrations in the blood within 40-60 minutes. If after this time the child's condition has not improved, the temperature indicators have remained at the same level, then it is necessary to seek help from an ambulance specialist.

The arrived team, most likely, will carry out the intramuscular injection of a lytic mixture consisting of analgin, papaverine or no-shpa and the antihistamine Tavegil.

Features in adults

In adult patients, cases of white hyperthermia are very rare. They are usually caused by congenital vascular pathology. Therefore, all first aid points at a child's temperature apply to the adult population.

The only difference is the broader list of offered antipyretic drugs. Age-restricted aspirin is very effective and can be used more widely in adults.

However, taking it also involves taking precautions. This drug can have an ulcerogenic effect, that is, cause the development of gastric ulcer and duodenal ulcer. In addition, influencing the coagulation properties of blood, uncontrolled use of the drug can lead to the development of bleeding.

So, in the case of an increase in body temperature to high numbers, first aid to the patient should be provided immediately. Since the development of hyperthermia can proceed in different ways, it is necessary to consult a doctor to choose the correct tactics.

In children, the correct dosage of the drugs used also plays an important role.

It is currently known that hyperthermia is a protective-compensatory reaction, due to which the body's immune response to the disease is enhanced, since:

blood bactericidal activity increases;

the activity of leukocytes increases;

the production of endogenous interferon increases;

the intensity of metabolism and metabolism increases.

Fever is based on an imbalance between heat production and heat transfer resulting from an infectious process, stressful situations, intoxications, allergic reactions and other causes. Fever plays its protective-adaptive role only up to certain limits. With a progressive increase in temperature, there is a significant increase in the load on respiration and blood circulation (for each degree of temperature increase over 37 ° C, the respiratory rate increases by 4 breaths per minute, pulse - by 10 beats per minute), which leads to an increase in oxygen supply to the blood. However, even such an increased amount of oxygen in the blood no longer provides the tissue requirements for it that increase with infections - hypoxia develops, from which the central nervous system suffers in the first place, and often children develop febrile convulsions.

In terms of temperature, fever differs by

subfebrile (37.2-38.0 ° C)

low (moderate) febrile (38.1-39.0 ° C)

high febrile (39.1-41.0 ° C)

hyperthermic - over 41.0 ° С

Fevers can differ in the type of temperature curve (this is when a graph is drawn up according to the indicators of the rise in temperature, and the name of the type of fever is given by the type of graph).

What is important for mothers to know and understand!

Fevers also differ in type: pink hyperthermia, at which the heat production is equal to the heat transfer and the general state is not changed, and white hyperthermia, at which heat production exceeds heat transfer, since a spasm of peripheral vessels occurs. With this type of hyperthermia, cold extremities, chills are felt, pallor of the skin, cyanotic shade of the lips, nail phalanges is observed.

Clinical picture

With a sudden increase in body temperature, a child has lethargy, chills, shortness of breath, he refuses to eat, ask for a drink. Sweating increases. If timely assistance is not provided, then motor and speech excitement, hallucinations, clonic-tonic convulsions appear. The child loses consciousness, breathing is frequent, shallow. At the time of seizures, asphyxia can occur, leading to death. Often, children with hyperthermic syndrome have circulatory disorders: a drop in blood pressure, tachycardia, spasm of peripheral vessels, etc.

The most dangerous variant of hyperthermia syndrome is malignant hyperthermia, which can be fatal. Malignant hyperthermia is rare, but it 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 hyperthermia syndrome, it is necessary to take into account not only the temperature value, but also the duration of hyperthermia and the effectiveness of antipyretic therapy. Fever above 40 ° C and malignant fever are an unfavorable prognostic sign. Prolonged hyperthermia is also a prognostically unfavorable sign.

The beginning of emergency care in children with hyperthermic syndrome are: a rise in temperature above 38 ° C, a history of febrile convulsions, hypoxic damage to the central nervous system of antenatal and perinatal origin, age up to 3 months of life.

First aid at high temperatures.

In most situations, fever is an adaptive response that enhances the immune response and increases resistance to infection. Therefore, theoretically healthy children are not recommended to prescribe antipyretic drugs if the body temperature does not exceed 39.0 ° C. For children with a history of febrile seizures, as well as with neurological diseases, it is permissible to carry out antipyretic therapy at temperatures above 38.0 ° C. To enhance heat transfer, the child is wiped with warm water or wiped with alcohol-containing liquids to eliminate spasm of skin vessels and improve microcirculation. Antipyretic drugs should not be prescribed for regular "course" intake, but only when the temperature rises above the specified level.

Antipyretic drugs.

When choosing an antipyretic drug, it is necessary to take into account its safety, possible routes of administration, the age of the child, the presence of children's dosage forms.

Paracetamol is the first-line drug for treating fever in children and is considered the least hazardous. Available in the form of tablets, syrup, drops and suppositories. A single dose of 10-15 mg / kg provides a decrease in temperature by 1-1.5 ° C. The daily dose should not exceed 60 mg / kg, due to the risk of liver damage.

Ibuprofen in liquid dosage forms is also approved for use in children. It has antipyretic, analgesic and anti-inflammatory effects, and is similar in strength to paracetamol. A single dose of 10-15 mg / kg. Side effects may include dyspeptic disorders, gastric bleeding, and decreased renal blood flow.

Analgin remains one of the most powerful and fast-acting antipyretic drugs. Available in the form of tablets and ampouled solutions, which makes it possible to use parenteral routes of administration. A single dose of 3-5 mg / kg, in the practice of intensive care, the ampouled form is usually prescribed at the rate of 0.1 ml of a 50% solution for 1 year of a child's life. In addition to other side effects inherent in pyrazolone derivatives, analgin can act depressingly on hematopoiesis, which was the reason for its prohibition in some countries.

Acetylsalicylic acid has antipyretic, analgesic, anti-inflammatory and antiplatelet effects. Single dose of 10-15 mg / kg. It should be remembered that in children with acute respiratory viral infections, influenza and chickenpox, the appointment of acetylsalicylic acid can lead to the development of Reye's syndrome, therefore, the use of the drug should be limited in children under 15 years of age.

Algorithm of actions in the provision of emergency care for hyperthermia in children, "white" hyperthermia.