Ethan Rhodes
Fever is a common symptom of illness and can indicate that the body is fighting an infection from a virus or bacteria. It can also be caused by an inflammatory disease, a reaction to drugs or vaccines, or certain types of cancers. Most doctors agree that a temperature of over 101°F is a fever. Fevers can sometimes go away on their own and do not need to be treated, especially if they are below 101°F. However, in cases of high fever or fever causing discomfort, medication such as acetaminophen or ibuprofen may be recommended. Hospitals may also employ physical cooling methods, such as external cooling to normothermia, to treat fever in critically ill patients.
| Characteristics | Values |
|---|---|
| Medication | Paracetamol, Ibuprofen, Acetaminophen (Tylenol), Advil, Motrin IB |
| Fluids | Drink plenty of water, clear broth, Pedialyte, diluted juice, popsicles |
| Clothing | Light clothing, avoid overdressing, use sheets or light blankets |
| Sponge/Immersion | Sponge exposed skin with tepid water, give sponge baths or let soak in a tub |
| Fan | Stand in front of a fan to boost the cooling effect of evaporation |
| Rest | Ensure plenty of rest, including bed rest |
| External Cooling | Cool to normothermia (36.5-37°C) for 48 hours |
| No Treatment | Fevers can help fight infection, so treatment may not be necessary |
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What You'll Learn
Use of medication such as ibuprofen or acetaminophen
While a mild fever can help the immune system fight off an infection, medication is sometimes required to reduce a person's temperature. Hospitals often use antipyretic medications such as ibuprofen or acetaminophen (also known as paracetamol) to reduce fever.
Ibuprofen is a non-steroidal anti-inflammatory drug that reduces inflammation, pain, and fever. It is available over the counter under brand names such as Advil and Motrin. Ibuprofen is generally safe for adults and children over six months old, but it should be used with caution by individuals with heart disease, high blood pressure, clotting disorders, or kidney problems. Pregnant women should avoid ibuprofen and consult a doctor before taking any medication.
Acetaminophen, commonly known by the brand name Tylenol, is a pain reliever and fever reducer. It is also included in hundreds of other medications, such as Excedrin, Nyquil, Sudafed, Mucinex, and Theraflu. While acetaminophen is generally safe for adults, it should be used cautiously by those with liver problems. For children under six months old, acetaminophen should only be given if instructed by a healthcare provider.
Both ibuprofen and acetaminophen are effective in controlling fevers, although ibuprofen tends to work better for children. When deciding between the two, individuals should consider their age, medical history, and any other medications they are taking to avoid overdosing. It is important to follow the dosage guidelines on the label and consult a doctor if symptoms persist or worsen.
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External cooling methods, e.g. sponge baths
External cooling methods are often used to reduce fever in hospitals. These methods include the use of cooling blankets, sponge baths, and ice packs applied to specific areas of the body. While the effectiveness of external cooling methods in reducing fever is supported by some studies, there is also controversy and conflicting evidence surrounding their use.
Sponge baths are a common external cooling method that can be used to help reduce fever. This involves using a sponge to gently apply tepid or room-temperature water to the patient's skin. It is important to avoid using cold water, as it can cause the skin to constrict blood vessels, trapping body heat and potentially leading to shivering, which can generate more heat. Sponge baths can be given to children or adults with a fever, providing a soothing and cooling effect.
Another external cooling method is the use of cooling blankets, which are designed to circulate chilled water or use other cooling mechanisms to lower body temperature. The use of cooling blankets in hospitals is somewhat controversial, as there is limited evidence on their effectiveness and potential side effects. Some studies suggest that external cooling methods like cooling blankets can successfully reduce body temperature and provide therapeutic benefits, especially in patients with septic shock. However, concerns have been raised about increased energy expenditure and patient discomfort associated with these methods.
In addition to sponge baths and cooling blankets, ice packs applied to specific areas of the body, such as the groin, neck, and areas near great vessels, can also help reduce fever. While this method is less effective than other external cooling techniques, it can still provide a degree of cooling. Additionally, evaporation combined with a fan can be used to enhance the cooling effect. This method involves using mist or a damp sponge and standing in front of a fan to accelerate the cooling process through evaporation.
It is important to note that while external cooling methods can help reduce fever, they should be used with caution. Prolonged or aggressive cooling can lead to hypothermia, which carries its own risks and complications. Additionally, fever is a natural response to infection, and mild fevers can help the body fight off infections. Therefore, the decision to use external cooling methods should be made in consultation with a healthcare professional, taking into account the patient's overall condition and medical history.
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Intravenous (IV) medications for infants
Fever management in infants and young children is based on their age group, host factors (age, immunization status, immune status), risk factors (exposure to sick contacts, recent antibiotic use, recent hospital stay), clinical appearance, and clinical judgment.
Intravenous (IV) acetaminophen is approved by the US Food and Drug Administration (FDA) to treat fever in children of all ages, including infants. Rectal acetaminophen is also an option for infants at home who cannot take oral acetaminophen. Acetaminophen is preferred for infants under six months old due to its safety profile, as ibuprofen can be associated with renal toxicity. Ibuprofen is slightly more effective and lasts longer than acetaminophen, and it also has an anti-inflammatory effect in addition to its antipyretic effect. However, alternating acetaminophen and ibuprofen is discouraged as it can lead to confusion and toxicity.
In terms of IV fluid therapy, the National Institute for Health and Care Excellence (NICE) has guidelines for managing IV fluids for children and young people under 16. This includes assessing fluid and electrolyte status and prescribing IV fluid therapy. If a child needs IV fluid resuscitation, glucose-free crystalloids containing sodium in the range of 131-154 mmol/litre are used, with a bolus of 20 ml/kg over less than 10 minutes. Pre-existing conditions, such as cardiac or kidney disease, should be considered as smaller fluid volumes may be needed. When initiating IV fluids for routine maintenance, it is important to measure plasma electrolyte concentrations and blood glucose, and to continue monitoring at least every 24 hours.
It is important to note that body temperature is not a reliable indicator of illness in babies and young children. A child may have a mild temperature of slightly over 37°C but seem happy and healthy. Fevers lower than 37.7°C usually do not need to be treated unless the child is uncomfortable. Most doctors agree that a temperature over 38.3°C is a fever.
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Monitoring and treating underlying causes
Fever is one of the body's most effective ways of fighting infection. It is part of the body's defence against infection-causing germs, such as viruses or bacteria. A higher body temperature helps the immune system respond more vigorously to the attack and makes it harder for these microbes to survive.
However, in some cases, a fever can indicate a serious illness, especially in young infants. In such cases, it is important to monitor the fever and treat any underlying causes. If a fever lasts for more than three weeks, either constantly or on several occasions, and there is no clear cause, it is usually called a fever of unknown origin. In these cases, a specialist may be required for further evaluations and tests.
For infants under two months old, a fever could indicate a serious infection that requires intravenous (IV) medications and round-the-clock monitoring. In older children, it is important to ensure they are dressed in light clothing, as overdressing can trap body heat and make the temperature go higher. It is also recommended to give extra fluids, such as breast milk, formula, or water for children over one year old.
For adults, a fever can be treated at home with over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB). It is important to stay hydrated by drinking plenty of fluids, especially water, and to avoid drinks that can cause dehydration, such as alcohol, tea, and coffee. Getting plenty of rest is also recommended.
In some cases, a fever may be a side effect of certain medications or vaccines. It is important to monitor any other symptoms that occur alongside the fever and to consult a doctor if there are any concerns.
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Drinking fluids and staying hydrated
Fever is often a sign that the body is fighting an infection. Fevers can be extremely common and often occur due to a virus, like a cold or flu. A fever can also occur after getting vaccinated, from getting overheated, or from a bad sunburn.
In addition to staying hydrated, getting enough rest and sleep is crucial for supporting the immune system and allowing the body to fight fever-causing viruses. Keeping the room temperature cool and sleeping with light bedding can also help keep the body temperature down.
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Frequently asked questions
Hospitals may use medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), or aspirin to reduce fever. These medications are antipyretics, which means they work to lower the body's temperature.
Some non-medical methods to reduce fever include drinking plenty of fluids, particularly water, and avoiding drinks like alcohol, tea, and coffee, which can cause dehydration. It is also recommended to eat light, easily digestible foods. Sponging exposed skin with tepid water and standing in front of a fan can help boost the cooling effect of evaporation. It is important to avoid cold baths or showers as they can cause shivering, which generates more heat.
A high fever, especially one over 102°F (38.9°C), often requires medical treatment. If your fever is accompanied by an infection, such as the flu, or other concerning symptoms, you should seek medical help right away. Additionally, if your fever lasts for more than three weeks with no clear cause, it is considered a fever of unknown origin, and you may need to see specialists for further evaluations and tests.
