When is Your Child's Fever Serious?

Posted by Ryan Schoonover, CPNP & Ann Marie Rogers, MD on Apr 30, 2018 12:10:06 PM

It seems that this time of year medical providers frequently receive questions and concerns about fevers.  If a child has a fever, parents feel like they need to rush them to the office, or, if after hours, to the ER to have them evaluated, which may or child's fever-519937-editedmay not be the correct course of action, nor even necessary. 

Let’s first try and define what a true fever is.  A true fever generally is defined as 100 degrees Fahrenheit.  If measuring the forehead with the fancy thermometers that cost $50, take it a few times and use the average, because of poor accuracy.

Do we need to worry about a fever?  In most cases no. A fever can actually be a good thing, as it is our body’s natural response to an exposure or an infection, and, in some cases chronic infection.  Immunizations can cause fevers and even overdressing your child can make it seem like they have a fever.  

If a child's fever reduces with Acetaminophen or Ibuprofen and he or she is, otherwise, acting ok, managing the fever and monitoring your child is an appropriate course of action. You don’t even necessarily need to give the child anything for fever if the child is still acting ok and not complaining of anything specific. 

If the child is uncomfortable, as typical with fevers above 102 – 103, administer the child some Acetaminophen or Ibuprofen to bring the temperature down to make them more comfortable.  In other words, treat the patient, not the fever.    

For infants though, fevers can be very serious, so if you have a baby under 8 weeks with a fever, you should contact your medical provider right away.

If you’re not sure if you should worry about a fever, call your provider and seek guidance from the trained triage staff to determine necessity for an office visit.  Some symptoms in conjunction with a fever warrant an evaluation within 24 hours. 

When should my child be seen for a fever?  Many viral illnesses are associated with fevers that can last up to 72 hours.  So if a fever lasts longer than 72 hours, contact your healthcare provider.  If the fever comes with specific complaints such as coughing or ear pain, you may want your child evaluated to rule our signs of bacterial infections.  A fever and flu-like symptoms should actually be seen within the first 48 hours so that Tamiflu may be initiated, if appropriate.  

Should I take my child to the ER in the evenings or the middle of the night if he/she develops a fever?  In most cases, simply having a fever shouldn’t warrant a trip to the ER in the middle of the night.  In fact, fevers are usually higher in the evening and night than during the day, so don’t be surprised if it is higher in the middle of the night.  It doesn’t necessarily mean they are getting worse.  In most cases, you can manage the child’s comfort level overnight and have them seen the next day, if needed.  Taking the child to the ER should be a last resort due to a number of exposures you and your family will get at the ER.

Remember, fevers are a natural response by the body to infection and represents defenses are working properly.  But, there are instances when fevers need to be evaluated as soon as possible.  I hope, after reading this, you will be better prepared to identify when those instances are.  But if not, that’s ok, you can always contact your healthcare provider and they can help walk you through it. 

Remember to wash those hands and keep your hands away from your face!!!!  

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Topics: Fever