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 Fever
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F.C. Binder
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What is a fever? 

Fever refers to an elevation in body temperature. Technically, any  body temperature above the normal oral measurement of 98.6 F (37 C) or the normal rectal temperature of 99 F (37.2 C)  is considered to be elevated. However, these are averages, and your normal temperature may actually be 1 F (0.6 C) or more above or below the average of 98.6 F. Body temperature can also vary up to 1 F (0.6 C) throughout the day. 

Thus, fever  is not considered medically significant until body temperature  is above 100.4 F (38 C). Fever serves as one  of the body's natural defenses  against bacteria and viruses which cannot live  at a higher temperature. For that reason, low fevers should normally go untreated, unless accompanied by troubling symptoms. 

Also, the body's defense mechanisms seem  to work more efficiently at a higher temperature.  Fever is just one part of an illness,  many times no more important than the presence of  other symptoms such as cough, sore throat, etc. 

Fevers of 104 F (40 C) or higher demand immediate home treatment and subsequent medical attention, as they can result in delirium and convulsions, particularly in children. 

How should I take a temperature for fever? 

Digital thermometers can be used to measure rectal, oral, or axillary (under the armpit) temperatures. The American Academy of Pediatrics does not recommend use of mercury thermometers (glass), and they encourage parents to remove mercury thermometers from their households to prevent accidental exposure to this toxin. 

Measuring an axillary (under the armpit) temperature for fever: 

Axillary temperatures are not as accurate as rectal or oral measurements, and these generally measure one degree lower than a simultaneously obtained oral temperature. 

  • Place  the tip of the digital thermometer in  your child's armpit. 
  • Leave in place about one minute  or until you hear a beep  to check a digital reading. 
Measuring fever by eardrum temperature: 

Tympanic (ear) thermometers must be placed correctly in your child's ear to be accurate. Too much earwax  can cause the reading to be incorrect. 

Eardrum temperature measurements are not accurate in small  children and  should not be used in children under 3 years (36 months) of age. This  is especially true in infants below 3 months of age when obtaining an accurate temperature is very important. 

Measuring fever by oral temperature: 
Children 4 to 5 years old and adults can have their  temperature taken with a digital thermometer under the tongue with their mouth closed. 
  • Clean the thermometer with soapy water  or rubbing alcohol and rinse. 
  • Turn  the thermometer on and place the tip of the thermometer as far back under the tongue as possible. 
  • The thermometer should remain in place for about one minute  or until you hear the beep. Check the digital reading. 

Avoid hot or cold drinks within 15 minutes of oral  temperature measurement to ensure correct readings. 

Measuring fever by rectal temperature: 
The American Academy  of Pediatrics recommends rectal temperature measurements for children under 3 years, as this gives the most accurate reading of core temperature. 

  • Clean the thermometer with soapy water or rubbing alcohol  and rinse with cool water. 
  • Use  a small amount  of lubricant, such as petroleum jelly, on the end. 
  • Place the child prone (belly-side down) on  a firm surface, or place your child face up and bend his legs to his chest. 
  • After separating the buttocks, insert the thermometer approximately ½ to 1 inch into the rectum. Do not inset it too far. 
  • Hold the thermometer in place, loosely keeping your hand cupped around your child's bottom, and keep your fingers on the thermometer to avoid it accidently sliding further into the rectum. Keep it there for about one minute, until you hear the beep. 
  • Remove the thermometer, and check the digital reading. 
  • Label the rectal thermometer so it's not accidentally used in the mouth. 

A rectal temperature will read approximately one degree higher than a simultaneously obtained oral temperature. 

Notes:
FCbinderMD
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EditText of this page (last edited April 29, 2010)

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