High Fever in a Child Older Than 1
If your child is flushed and hot, your first instinct may be to see a doctor as quickly as possible, but this may not always be necessary.
“We constantly try to teach parents not to look at the thermometer, but what kids' symptoms are and what they look like,” says Schmitt, who created the KidsDoc app for smartphones from the American Academy of Pediatrics (AAP), a triage system that helps parents figure out how to treat kids' symptoms.
A fever is part of the body’s way of defending itself against an infection. If a child has a fever, it means that his immune system is working. A fever, by definition, is 100.4 F, taken rectally. You may want to take a toddler’s temperature under his arm, but be sure to add one degree to it, to get a more accurate number.
You can give your child medicine such as acetaminophen or ibuprofen (if the child is more than 6 months old) to reduce his fever. But be sure that it's truly necessary, and keep close tabs on the dosage of this or any medication in children, whether it's from a prescription or not. Remember, fever reducers don’t fight the infection that's causing the fever.
Bad Headache
How can you tell whether your child's headache is serious enough to warrant immediate medical attention, or if letting her skip school and sleep it off would help?
“Minor headaches go away with over-the-counter pain relievers or rest,” Brown says. “Major headaches do not.”
If your child's headache endures for several hours - or if the pain is so intense that she can't eat, play, or even enjoy her favorite TV show - call the pediatrician.
“If it's severe enough to incapacitate the child, it needs to be evaluated now,” Schmitt says. “They cannot do any normal activities. All they can do is think about their pain.”
Headaches can be commonly caused by tight muscles in the scalp, rather than a problem related to the brain, but a headache with neurological symptoms (such as confusion, blurred vision and trouble walking) should be evaluated by an emergency room doctor.
Headaches combined with fever, vomiting, confusion or stiff neck should also be evaluated quickly as the child could have a serious infection or illness, such asmeningitis, which is a medical emergency.
If a child gets headaches often, that needs to be evaluated. Children generally should not get headaches.
Widespread Rash
Don't be too concerned about a rash on your child's arm or feet; they're generally harmless. If the rash covers her entire body, though, examine it to see whether you should get medical attention.
“If you touch the red rash and it blanches or turns white, then you let go and it turns red again, you usually don't have to worry about it,” Sacchetti says. “Most of the virus rashes and allergic reactions, including hives, will do that.”
A non-blanching rash -small red or purple spots on the skin that don't change color when you press on them - can indicate a medical emergency such as meningitis orsepsis, particularly when accompanied by a fever. This type of rash can also appear on the face after violent bouts of coughing or vomiting, so it's not always a sign of something serious.
To be safe, any time your child has small red or purple non-blanching dots appear on a widespread area, it's best to seek emergency care at once, to rule out a more serious condition.
Another widespread rash which can be a medical emergency are hives which appear with lip swelling. Hives should be immediately treated with diphenyhadramine (Benadryl). If there is lip or facial swelling, the child must see a doctor. If your child's breathing is labored or your child complains about breathing, call 911 -- the symptoms suggest anaphylactic reaction, which is a serious, life-threatening allergic reaction.
Severe Stomach Bug
When your child has food poisoning or gastroenteritis (the so-called “stomach flu," though it has nothing to do with influenza), monitor how often they're throwing up or having diarrhea.
Vomiting and diarrhea can lead to dehydration. If it is mild dehydration, your doctor may recommend giving electrolyte solutions at home, though treatment depends in part on the child's age. If your child seems to be getting worse (not voiding enough or acting sick), you should see your doctor.
Vomiting three times in an afternoon may not lead to dehydration, but eight bouts of diarrhea in eight hours probably will, as will a combination of vomiting with diarrhea. Dehydration needs to be closely monitored and sometimes needs emergency treatment.
“If they're losing it below and not able to retain the ideal fluid from above, they may need some IV fluids or prescription medication to stop the vomiting,” Schmitt says. “The younger kids are at the greatest risk of dehydration.”
Stiff Neck
A stiff neck can indicate meningitis, a true medical emergency, so parents may panic if they see their child standing rigidly, refusing to look left or right. But a stiff neck by itself is rarely anything more than sore muscles.
“Look at a constellation of symptoms, not just one in isolation,” Brown says. “A stiff neck alone might mean you slept funny. Meningitis is a combination of fever with a stiff neck, light sensitivity and headache.”
A stiff neck with a fever might be tonsil inflammation, not meningitis; calling the pediatrician could ease your fears. Of course, if trauma caused a hurt neck, that's a clear reason to head to the ER.
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