Thursday, June 21, 2007

Fever: To treat or not to treat?

Fever is defined as a body temperature higher than 37C. Many of my patients suffer from what we called "fever phobia", the irrational fear that body temperatures from 37.8-40C will cause severe harm eg brain damage to their children, themselves or loved one and they quickly find solution to their fever.Actually, the decision to treat fever is based on patient because fever is not associated with many harmful effects unless temperature exceeds 39.4-41.1C. In fact, many microbs or bacteria is thermolabile, therefore, their growth is impaired by higher than normal temperatures.

Clinical reports already suggest treating conditions like chicken pox may increase the duration of the symptoms compared with no treatment. Also, treatment of rhinovirus with aspirin may increase viral shedding. This is because fever increases oxygen consumption, production of carbon dioxide, and cardiac output. Specifically, fever increases the release of interferons, neutrophil release and improve chemotaxis, thus boosting up the activity of the immune system, helping patient to combat viral and bacterial infections.

So to treat or not to treat fever, and when to treat? Buy a thermometer and monitor your fever.
How do we choose which type to buy? How many types of thermometer available in the market?
Glass/plastic thermometer
1)Low cost
2)Light weight
3)Compact size

1) Extra care in rectal measurement as it can break
2) Glass or plastic may break
3) Proper storage ie cool location, out of sunlight

Electronic thermometer
1) Register reading quickly
2) Not subject to glass breakage and risk of cuts
3) Can used with disposable covers to eliminates the need to disinfection after use
4) Easier to read

Tympanic thermometer
1) Most accurate as it measure tympanic membrane(close to the hypothalamus)
2) Measurement takes only 1 second, appropriate for baby and small children

1)Slightly expensive

Skin thermometer
1) Easy to use
2) Relatively cheap

1) Only measure skin temperature (which can be influenced by environment and skin perfusion
2)Only useful in noting temperature trends but not absolute temperature

Ask the pharmacist!
1)Do you think you know how to measure body temperature correctly?

0-3 months old-Rectal method is preferred because due to the size and shape of infant's ear canal, the tympanic thermometer is not indicated.
3 months to 5 years old- Axillary or tympanic method is preferred. Rectal may cause discomfort.
More than 5 years old- Oral or tympanic method is preferred.

2)When the body temperature exceed 40C, sponge the body with lukewarm water(not cold) water. Usually the person must wait 1 hour after a dose of fever medicine before sponging the body.
3)Wear light clothing, remove blanket, and maintain room temperature about 25-26C.
4)Drink sufficient fluids to replenish body fluid losses.5) But still, remember to seek medical attention if the fever persists after 3 days of treatment or fever continues to increase during treatment (>39.4C, or history of febrile seizures) because you need to treat the underlying cause of the fever.
6) Email me if you want to know more or want to buy a thermometer for your family...

1 comment:

zewt said...

hmmm... very informative indeed...