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Instructions

• Instructions for new users

Call 911 Now If:

• Not moving or very weak
• Unresponsive or difficult to awaken
• Difficulty breathing with bluish lips
• Rash with purple (blood-colored) spots or dots

Call Your Doctor Now If:

• Your child looks or acts very sick
• Any difficulty breathing
• Great difficulty swallowing fluids or saliva
• Child is confused (delirious) or has stiff neck or bulging soft spot
• Had a seizure with a fever
• Age < 12 weeks with fever > 100.4°F (38°C) rectally (Caution: do NOT give these babies any fever medicine before being seen)
• Fever > 105°F (40.6°C) at any age
• Very irritable (e.g. inconsolable crying or cries when touched or moved)
• Won't move an arm or leg normally
• Signs of dehydration (very dry mouth, no urine > 8 hours, etc.)
• Chronic disease that causes decreased immunity

Call Your Doctor Within 24 Hours If:

• You think your child needs to be seen
• Age 3-6 months with fever
• Age 6-24 months with fever present > 24 hours but no other symptoms (e.g. no cold, cough, diarrhea, etc.)
• Fever repeatedly > 104°F (40°C) despite fever medicine
• Burning or pain with urination
• Fever lasts > 3 days (72 hours)

Call Your Doctor During Weekday Hours If:

• You have other questions or concerns

Home Care (Read "Call Your Doctor…" first):

Reassurance

Presence of a fever means your child has an infection, usually caused by a virus. Most fevers are good for children and help the body fight infection.

Use the following definitions to help put your child's level of fever into perspective:

• 100-102°F (37.8-39°C): low grade fever and beneficial, desirable range
• 102-104°F (39-40°C): moderate fever, still beneficial
• > 104°F (40°C): moderately high fever and causes discomfort, but harmless
• > 105°F (40.6°C): high fever - higher risk of bacterial infections (3% risk)
• > 106°F (41.1°C): very high fever - important to bring it down
• > 107°F (41.7°C): dangerous fever - the fever itself can be harmful to the brain

Treatment for All Fevers is Extra Fluids and Less Clothing

• Give cold fluids orally in unlimited amounts. (Reason: good hydration replaces sweat and improves heat loss via skin)
• Dress in 1 layer of light weight clothing and sleep with 1 light blanket (avoid bundling). (Caution: overheated infants can't undress themselves)
• For fevers 100-102°F (37.8-39°C), this is the only treatment needed (fever medicines are unnecessary)

Fever Medicine

Give acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Advil) for fevers above 102°F (39°C), if your child is uncomfortable. The goal of fever therapy is to bring the temperature down to a comfortable level. Remember, the fever medicine usually lowers the fever by 2 to 3°F.

Avoid aspirin. (Reason: risk of Reye's syndrome, a rare but severe brain disease)

Sponging

Sponge for fever > 104° F (40°C) that doesn't come down with acetaminophen (e.g. Tylenol) or ibuprofen AND causes discomfort.

How to sponge:

• Use lukewarm water (85-90°F) (29.4-32.2°C). (Do not use rubbing alcohol)
• Always give fever medicine first. Sponge for 20-30 minutes. If your child shivers or becomes cold, stop sponging or increase the water temperature. (NOTE: Sponging is optional for high fevers, not required)

Contagiousness

Your child can return to day care or school after the fever is gone.

Expected Course of Fever

Most fevers associated with viral illnesses fluctuate between 101° and 104° F (38.4° and 40°C) and last for 2 or 3 days.

Call Your Doctor If:

• Fever goes above 105°F (40.6°C) or repeatedly above 104°F
• Fever without a cause persists > 24 hours (if age < 2 years)
• Any fever occurs if < 12 weeks old
• Fever lasts > 3 days (72 hours)
• Your child becomes worse or develops any of the "Call Your Doctor…" symptoms