38 and above... What to do if the newborn has a heat?
the Increased temperature at the baby - the frequent reason of alarm of parents. Whether fever is really so dangerous and what needs to be done in house conditions if the kid “burns“?
Fever - whether it is always bad
the Increased temperature (fever) is not an independent disease though this symptom can accompany many diseases. All fevers can conditionally be divided on:
infectious (the reason causing temperature increase of a body various pathogenic viruses, bacteria are);
noninfectious (functional) which cause the various factors influencing work of the center of thermal control can be. Temperature increase can meet at various endocrine diseases as a result of effect of some hormones, at dehydration, neurosises, the increased physical and emotional activity, etc.
the Center of thermal control is a part of the central nervous system, is located in department of a brain - a gipotalamus and carries out regulation of processes of heat generation and a thermolysis, being responsible for maintenance of constant normal body temperature.
At infectious fevers temperature increase of a body plays a protective role. In such conditions growth and reproduction of bacteria decreases, for many viruses the only pernicious factor is high temperature. At fever to 39 °C in a human body proteins of immune protection - immunoglobulins are actively produced, exchange processes become more active. However at excess of a certain threshold (at each person it is individual, but averages about 39 - 39,5 °C) protective function of temperature reaction weakens. In such conditions providing fabrics with oxygen decreases, the main processes of a metabolism and activity of many cages of an organism suffer, first of all the central nervous and it is warm - vascular systems. Therefore to a certain level fever in itself is a protective factor, and only at achievement and excess of this threshold use of the febrifugal methods which are a part symptomatic (i.e. eliminating painful symptoms) is necessary for therapy.
In cases of noninfectious fevers the increased body temperature is only the reply of the center of thermal control to influence of various factors (hormones, biologically active agents) and, as a rule, has no protective or compensatory character. Such fevers usually will not respond to treatment febrifuges therefore therapy is directed to elimination of a provocative factor (elimination of a hormonal imbalance, soothing preparations etc.) .
What temperature to consider
the majority of systems of an organism though are created by
At just been born kid, but functionally nezrela. It is fair also for the central nervous system, and for its part - the center of thermal control. Therefore processes of formation of heat and its allocation are also imperfect. Newborn, especially premature, are extremely sensitive to environmental conditions - easily overheat and easily freeze.
Normal body temperature at newborns fluctuates in the range of 37,0+0,5 °C and depends on the place and time of measurement. The highest rates of temperature are registered from 18 to 22 o`clock in the evening, and the lowest body temperature is characteristic of early morning hours. It is possible to take temperature in a rectum (rectal temperature), in an axillary hollow (axillary), in a mouth (oral), in an inguinal fold. The most high temperature is defined in a rectum, on average it does not exceed 37,6 °C though sometimes and normal can reach 38,0 °C. It is about 1 °C more than axillary (axillary) temperature and temperatures in a mouth are 0,3 - 0,4 °C higher. However for each kid there is an individual temperature norm which can differ from the general average values. To define individual norm of your baby, it is necessary to take him temperature when it is healthy, quiet (in the absence of signs of an indisposition, an illness) 3 times a day (in the morning, in the afternoon and in the evening). Recommend to take kids till 5 - 6 months rectal temperature.
First aid to the newborn at high temperature
the Main thing governed
: to all newborns with the increased temperature it is necessary to call the doctor! Temperature increase of any level at the age of the child is considered less than three months dangerous.
the Most exact device for determination of temperature remains the mercury thermometer. For measurement of rectal temperature use thermometers with a thick roundish mercury-containing flask. Modern electronic thermometers faster and safe, however they can distort temperature indicators on several tenth shares of degree. When using ear thermometers it is necessary to arrange correctly the sensor in an auricle, otherwise it is possible to obtain incorrect data. Lamellar liquid crystal thermometers give only approximate information on body temperature. Oral thermometers (in an oral cavity) can only be used to measurement of temperature with 4 - 5 - summer age of the child, and there is actual a problem of “a device razgryzaniye“.
the General actions
All processes at newborns develop promptly, deterioration in a state can happen very quickly. Therefore at any guarding symptom (and temperature increase, certainly, is that) it is necessary to communicate and consult immediately with the treating pediatrician or to call “ambulance“. >
it is obligatory for p to call “ambulance“ it is necessary if the taken temperature in an axillary hollow of 39,0 - 39,5 °C, and rectal temperature exceeded 40,0 °C. It is necessary to tell that even at the established diagnosis very high temperature nevertheless is dangerous from - for probabilities of development of a so-called hyper thermal syndrome. At the same time the fast and inadequate temperature increase of a body which is followed by violations of supply of bodies and fabrics with blood from - for violations of blood circulation in small vessels is noted, up to malfunction of vitals (a brain, heart). One of bright manifestations of such syndrome are spasms. Therefore substantial increase of temperature at the kid requires special attention.
to facilitate health of the child, before arrival and consultation doctors parents can independently execute a number of actions.
First that needs to be made - to create to the kid comfortable conditions of environment. The room needs to be aired. Air temperature indoors has to be about 20 °C (19 - 21 °C). Owing to imperfection of processes of thermal control at the newborn the increased temperature and humidity in the room can lead to overheating of the child. It is possible to use the fan or the conditioner, avoiding the direct direction of a current of air on the baby.
should not be wrapped up with
of the Kid with fever. On the contrary, the child it is necessary to open, put on him an easy cotton jacket or a kombinezonchik. It is important to remember that the disposable diaper can close up to 30% of a surface of a body of the child, interfering with normal sweating, heat exchange. Therefore, especially if there is no opportunity to reduce temperature indoors, it is better to remove a diaper from the newborn. > As it is correct to p to take
Should remember that temperature needs to be taken when the kid is quiet as crying, the excited state, overheating, physical activity promote temperature increase of a body. At measurement of temperature in natural folds of a body (an inguinal, axillary hollow) they need to be wiped carefully as moisture underestimates thermometer indicators. After crying, it is necessary to wait for emotional or physical excitement of the child not less than 30 min. And to take temperature in a quiet state.
For determination of rectal temperature at the newborn should be put the kid on a back (it is possible to itself on knees), to lift and take away legs as at a podmyvaniye, to grease anus skin with children`s cream (it is also possible to grease with a thin layer of cream and a thermometer flask, however it is necessary to remember that the thick layer of greasing can distort device indicators). Previously having shaken a mercury column marks of 36 °C are lower, it is necessary to enter the thermometer into back pass on depth about 2 cm. Then it is necessary to reduce and take legs of the kid in such situation not less than 3 min. >
If does not manage to take p rectal temperature, the kid cries, calm him, and after a while take temperature in an axillary hollow. At the same time the child can be at you on hands. The taken temperature and time of measurement needs to be written down that then to show to the treating pediatrician: the made schedule of temperatures (a temperature curve) can help at statement of the diagnosis.
At the increased liquid loss that is often observed at fever, and also can be aggravated with presence of vomiting, diarrhea, at newborns quickly dehydration develops. Dehydration in itself can promote temperature increase of a body of the child. Dopaivaniye - the main method of fight against dehydration. The children who are on breastfeeding the thicket needs to put to a breast (in women`s milk a lot of water). At refusal of the baby of milk, and also the kids who are on artificial feeding should offer fenkhelevy tea, boiled water. Liquid needs to be given small amounts (to the kid of the first month - on one teaspoon each 20 - 30 minutes) as at the same time drunk large volume of liquid can independently provoke vomiting as a result of restretching of walls of a stomach. At sharp dehydration the doctor can appoint special salt solutions for newborns. In hard cases hospitalization can be required.
Physical methods of decrease in temperature
as the pre-medical help to children at fever are widely used by
various physical methods of decrease in temperature. Increase in a thermolysis is the cornerstone of these ways.
in the Most widespread way of not medicinal decrease in temperature is rubdown. The newborn is undressed and rub off his little body the napkins moistened in water with a temperature of 36 - 37 °C. Rubdown by water of lower temperature can cause a shiver that, in turn, only promotes additional temperature increase of a body.
of the Kid is spread on a diaper with the oilcloth spread under it. Water of necessary temperature have a row. Having moistened a napkin, it is necessary to wring out it, and then the careful not pounding movements to rub off the child`s body from the periphery (since handles, legs) to the center. The easy friction promotes reflex expansion of vessels that improves a thermolysis, and evaporation of water strengthens this process. Water periodically should be diluted with warmer, without allowing its considerable cooling and maintaining water temperature close to normal body temperature.
are not recommended to
of Rubdown by solutions of alcohol, vinegar or vodka now as steam inhalation of these substances can be unsafe for the child, and intensive evaporation can provoke a muscular shiver and increase temperature.
On a forehead to the baby can put a cool compress - the napkin moistened in water of room temperature. It is necessary to moisten periodically a napkin with water that the compress did not turn into warming.
are practically not applied Now by wrappings a damp sheet as it complicates sweating - a natural way of a thermolysis. Body temperature will quicker decrease at open skin. Also enemas with cool water are seldom used.
In cases of very high temperature (it is above 39,5 °C) on area of large vessels (in a groin, in axillary hollows, popliteal and elbow bends, on temporal and carotids) for increase and acceleration of return of heat are put by the ice pieces wrapped in fabric. There are special freezing gels, packages or hot-water bottles with which it is also possible to use in such situations.
the Main rule - medicines can give
to the newborn only according to the recommendation of the treating pediatrician. It is impossible to be guided by your personal, previous experience or extensive experience of grandmothers, neigbours and acquaintances at all. The children`s doctor has to assess each situation and, considering all indications and contraindications, to appoint the corresponding treatment in a necessary dosage.
In cases of noninfectious fever it. Additional diagnostics for establishment of the reason of temperature increase at the newborn can sometimes be required.
the doctor will appoint by
At infectious fevers the treatment directed to suppression of the pathogenic agent - viruses or bacteria. At viral diseases it can be purpose of Interferon or the preparations strengthening production of Interferon in an organism; at the diseases caused by bacteria antibiotics are appointed. The question of need of use of febrifuges (antipiretik) at the kid is younger than 1 month (newborn) is solved the attending physician.
in pediatric practice most often use Now febrifugal preparations in which active ingredient is or Paracetamol , or the Ibuprofen . These are the safest (especially an ibuprofen), the effective and well studied antipiretik allowed for use at children from 6 months. For children the question of use of Paracetamol is younger than this age or of the Ibuprofen is solved the attending physician depending on a concrete situation. Preparations are used in the form of suspensions, syrups or rectal candles.
should pay Special attention to a single and daily dosage of a preparation (it pays off on the actual weight of the kid). Excess of a dose of medicinal substance can cause various, sometimes very heavy, side effects and toxic reactions. So, for example, overdose of Paracetamol causes toxic damage of a liver and kidneys.
in children`s practice widely used Earlier acetilsalicylic acid ( Aspirin ), however data of scientific researches revealed dependence between reception of Aspirin at viral diseases at children and development of a syndrome of Ray - a severe damage of a brain and a liver. Therefore now Aspirin is not recommended for treatment of children 15 years are younger.
Analginum (metamizol) still is issued the Russian farmpredpriyatiya though in many countries of the world application of this preparation is forbidden or sharply limited. It is connected with the heavy collateral reactions caused by Analginum : serious violations of blood formation, anaphylactic shock (allergic shock reaction), immune damage of a liver, lungs, kidneys. Since 1992 Farmkomitet the Russian Federation made the decision to limit use of metamizol for children and teenagers till 18 years. However it should be noted that doctors of the fast and urgent help if necessary with success apply it a preparation to babies.
Amidopirin and Fenatsetin with 60 - x years of the 20th century are withdrawn by
from the list of febrifugal preparations in connection with heavy toxic reactions and oppression of blood formation against their application. However production of these preparations in our country to these time is not stopped.
Action of febrifugal preparations can be estimated in 30 - 40 min. after their reception. On average they reduce temperature by 0,5 - 1,5 °C, however the effect in many respects depends on individual sensitivity to a preparation.
Once again should remind
that fever is only a symptom which demonstrates change of operation of mechanisms of thermal control of an organism. Therefore therapy first of all has to be directed to elimination of the reasons which caused fever. Febrifuges are the auxiliary, symptomatic treatment improving health of the patient.