Dr. Hands gives some tips on how to measure the fever temperature in children.
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Understanding Fever Temperatures in Children Our topic now is fevers in children. Now a fever means different things in different age groups. First, I just want to mention that there are different ways to take temperatures. The old mercury glass thermometers now sort of in disrepute because of the fear of the breakages and escape of the mercury. But there are oral, axillary and rectal temperatures that are used with most often digital thermometers are used for this. Rectal temperatures are avoided however, if there is any rectal disease. They’re avoided in newborns and axillary temperatures are more common in kids. Axillary temperatures do have problems related to little babies, brown fat collection which gives a lot of extra heat in the axilla. They also can be affected by technique. They can be affected by ambient air and other things that make them not always accurate. Rectal temperatures are core temperatures. They’re accurate but they tend to be more traumatic and as I mentioned they are counter indicated in the patients that we just mentioned. Oral temperatures are problematic in younger kids. One, they refused to do it and some of the older kids, the problem is they are affected by what they’ve eaten, the affect of inhaling a lot of the air from the environment. Therefore, all temperatures have their problem too. Temperatures are also taken by infrared techniques. Some people are familiar with the temperatures that are taken in the ear that way. These temperatures however -- and the ear temperatures are somewhat questionable and are not always accurate. There are also liquid crystal skin temperatures which the thermometer is put on the skin, which change colors to the chemical reactions. Actually these can be done with temperature being taken in on a continual basis as a thermal reading from the skin. Plastic strip thermometers were popular at one time. There are many ways temperatures can be taken. However, the things to remember are infant’s temperatures tend to be higher than adult temperatures. Rectal temperatures are higher than auxiliary and oral temperatures. But temperature means different things in different age groups. If you have a temperature under three months it creates a major concern to your child. This is a reason for probably contact of your pediatrician because under three years, every three months of age, children localize infection poorly. Their immune system is certainly more immature and these kids are at higher risk of having more severe illness with simple temperatures. Over three months of age, these children are basic to be guided more like older children in general. They are evaluated strictly on the basis of their clinical disease and the health that they present with. Older children do not need necessarily urgent attention immediately with a temperature as do the younger kids. Certainly, we are much more careful with children under a year than we are with children over a year but yet the immune systems are more mature and basically they’re regarded in a similar way. Remember young children, that is children under a year, under two years, when higher fever is often and so parents often get very scared with hyperthermia. The truth is there is no correlation with height of temperature and severity of disease. Nor is there correlation with height of temperature and its response to Advil or Tylenol, antipyretics. Nor is the response itself indicative of a worrisome disease or not. That is if a child doesn’t respond to Tylenol are they more sick than if they do? The answer is there is no data to substantiate that. Now temperature per se in kids, in older kids is not the medical concern that parents have. The underlying disease is the important aspect of temperature, not fever itself. We call it in medicine fever phobia and most likely people have it. That is they have the connotations of fever per se, will “fry their brain,” will hurt them in some way. The
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