What to do in a Medical Emergency

Fever

FeverFever by itself is not an illness, but a symptom for a range of medical conditions. It also can be a side effect of some medications. Fever is one of the most common reasons that parents visit an emergency department with a child. 

Elevated body temperature also plays an important role in the body's normal response to fighting infection. Most people consider 98.6 degrees Fahrenheit (F) (37 degrees Celsius [C]) a healthy body temperature, but a person's normal body temperature may vary a degree or more, and it fluctuates during the day (lower in the morning, higher at night).

Fever in an adult usually isn't usually dangerous unless it registers 103 degrees F (39.4 degrees C) or higher.  If it is accompanied by any of the following symptoms, it may indicate a serious or life-threatening illness. Seek immediate medical attention if your symptoms include:

  • Pain or tenderness in the abdomen.
  • Nausea or vomiting.
  • Severe headache.
  • Stiff neck that resists movement.
  • Light hurts eyes.
  • Convulsions or seizures.
  • Difficulty breathing.
  • Strange behavior, altered speech.
  • Mental status changes, confusion, difficulty waking, extreme sleepiness.
  • Rash (particularly if it looks like small bleeding spots under the skin).

Drink plenty of fluids to avoid dehydration. For children under age one, the best liquid is an oral rehydration solution, such as Pedialyte.®

For children, fever is considered a rectal temperature of above 100.4 degrees F (38 degrees C) or an oral temperature above 99.5 degrees F (37.5 degrees C). (Rectal temperature readings are usually about 1 degree F higher than oral readings.)

Although rare, some children under age five can experience seizures, especially if the child's temperature rises or falls rapidly. Seizures can be very alarming to parents, but they do not cause any permanent harm in most children.

Call your pediatrician or seek emergency care if your child has a fever of 104 degrees F (40 degrees C) or higher. Until you get help, remove any unnecessary clothing and try to cool the child down. If at home, you can sponge the child with lukewarm water, place the child in a tub of cool water or let the child rest under a single layer of thin towels which have been dipped into cool water and wrung out. Don't let the child get chilled. Don't use alcohol or ice water. Take steps to ensure that the child remains as cool and comfortable as possible while enroute to the emergency department.

Contact a physician for any child with a fever who:

  • Is under three months of age and whose temperature is greater than 100.4 degrees F (38 degrees C), because infants don't have well-developed immune systems and could have serious infections.
  • Has a body temperature higher than 102 degrees F (38.8 degrees C).
  • Looks very sick, is unresponsive and uninterested in the surroundings, is sluggish and won't suck on breast or bottle.
  • Cries constantly, continuously or without relief.
  • Is difficult to waken.
  • Has a stiff neck.
  • Has purple spots on the skin.
  • Has difficulty breathing.
  • Is drooling excessively or having great difficulty swallowing.
  • Has symptoms of earache or sore throat.
  • Has a limp or will not use an arm or leg.
  • Has significant abdominal pain.
  • Has painful urination or difficulty urinating.
  • Has any amount of redness or swelling on his or her body.
  • Has a seizure (fit or convulsion).
  • Becomes dehydrated.

Most illnesses associated with fever run their course over a period of time and can be treated with acetaminophen or ibuprofen (unless the person is allergic or has been advised by a physician not to take these medications).

Aspirin should not be given to children or teenagers under age 19 because of the possibility of developing Reye's Syndrome, a rare but potentially fatal medical disorder. In addition, ibuprofen is not recommended for infants younger than six months of age.


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