blog twincity pediatrics

Have you met our nurse practitioners?

We are delighted to have two extraordinary nurse practitoners, Danielle Keever and Whitney Ewing, as part of our team at Twin City Pediatrics. These wonderful providers are beloved by our patients and deliver quality and compassionate care to each child they see. For those of you who are unfamiliar with what a nurse practitioner does, here is a brief explanation.

A nurse practitioner (NP) is an advanced practice registered nurse (APRN) who is qualified as a medical provider having completed a Master's degree in nursing (MSN) and an additional two years of required clinical education. NPs diagnose medical problems, order treatments, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. NPs tend to concentrate on a holistic approach to patient care, and they emphasize health promotion, patient education/counseling, and disease prevention. Most NPs maintain close working relationships with doctors and consult them as needed.


January 18, 2015

FYI: Debunking Fever Myths

 

Uh oh, fever strikes. Often in the late afternoon or evening after the doctor's office has closed. What to do? Depending on who you ask, you may get many different opinions about how to manage your child's fever. There are so many myths out there about fevers - here's hoping I can debunk some of those myths and give you some helpful information that you can use in the middle of the night! 

First, what IS a fever? A fever is the body's natural response to infection. When the body detects a virus (such as the common cold or flu) or bacteria (such as strep throat or ear infection), it's natural response is to "turn up the thermostat" in the body to help fight that infection. Therefore, a fever is not bad - it signals that your body's immune system is working to fight the infection. In children, a true fever is a measured temperature greater than 100.4°F. Although temperatures of 99-100 may seem warmer than normal, kids' temperatures vary throughout the day, and this can just be a normal variation.

Now, let's talk about those famous fever myths (they're not true!)...

  • Fevers are bad and must be treated immediately: As I mentioned before, fevers are the body's natural way of fighting infection. Do you always have to treat a fever? Not necessarily! If your child doesn't seem bothered by it and is active and playful and eating, it's okay to hold off on any medications.
  • Fevers cause brain damage ("fry the brain") or cause the blood to boil: Nope. Fevers don't usually get over 105, and it takes temperatures towards 107 to cause any long term damage. These types of temperatures are usually induced from heat related illness and not fevers.
  • If I don't treat a fever, it will cause a seizure: It's true that fevers can cause febrile seizures in young children, but only in 4% of children. There's not data to support that treating fevers prevents these seizures. And, while they're scary, they don't increase the risk of developing a seizure disorder.
  • If my child feels warm, he has a fever: Don't get me wrong, most parents out there do have superpowers for being able to tell when their child has fever, BUT, don't let it stop you from grabbing the thermometer. Many children can feel warm at 99-100, but don't have an actual fever. It's VERY helpful when you visit the doctor if you've taken the temperature at home.
  • Feed a cold, starve a fever: This is an old wive's tale. For any type of illness, it's important to maintain good nutrition and hydration. Though your child may not feel like eating normally if febrile, it's important that you keep them drinking fluids. Chicken noodle soup never hurts either!
  • Teething causes a fever: It's true that teething can cause a slight temperature elevation (think 99-100), but it should not cause a true fever. There's another reason for it if it's there!
  • Rubbing alcohol or an ice bath should be used to bring a fever down: Not a good idea. This may bring the temperature down too rapidly and may be dangerous. Instead, put your child in a lukewarm to warm bath to help.
  • If your temperature naturally "runs low," you have a fever at 99: Again, the body's temperature changes during the course of the day and may be a sign of normal body function rather than fever.

The moral to the story? A fever isn't always necessarily an emergency and it's a normal response to infection. That being said, if your child is limp and floppy, not drinking (and not peeing), not responding normally, has a seizure, or just isn't acting right (or if you have other concerns), always contact your doctor immediately. Likewise, if your infant under 2 months has a fever, it IS an emergency and needs immediate evaluation. We also need to hear from you if a fever lasts for several days in a row.

A few other take home pearls:

  • Treat fevers with acetaminophen or ibuprofen (if over 6 months). Call your doctor if you have questions about dosing.
  • For children under 3, the most reliable way to get a temperature is to take it rectally. See the AAP's guide to taking temperatures for help on how to do it properly (and what to do when they get older). 
  • Always use a digital thermometer. Old mercury thermometers are no longer safe. 
  • Fevers cause you to lose more fluids faster - keep your child well hydrated!
  • Take the fear out of fever with more information from the AAP