Childhood
A high temperature, or fever (they are the same thing ) in a child can cause a great deal of anxiety, frequently a lot more anxiety than the underlying illness causes. Little Jonny has an ear infection, mum is not greatly worried and with suitable treatment comforts him through his earache. Add in the fever that Jonny is almost certain to have at the same time and now Mum is worried. Not about the ear infection, she knows that will get better, it is the high temperature that she is worried about. When she contacts the Doctor she is not looking for treatment for an ear infection, she is looking for something to bring the temperature down.
A fever is the most obvious outward sign of the majority of kids illnesses. We have all had a fever and know how grotty you feel at the time. You ache all over, you are alternately shivering with cold, or pouring with sweat. You have a headache and feel tired, but can not sleep. This is a familiar set of symptoms for most people. There is absolutely no reason to think that a child with a fever feels any different to how the rest of us would feel with the same fever. Just because a baby or toddler can not describe in words how unwell he feels, the anguished screaming tends to give the general idea that baby is not happy!!
The important thing to remember is that a temperature is not an illness itself, it is just a symptom of something else. Usually an infection of one sort or another is the cause of a fever. Raising the bodies temperature helps the immune system to combat the infection more effectively. So before spooning in the Calpol, pause for a moment and spare a thought for what are you actually treating.
Given that 99% of fevers are going to be because of trivial viral infections, it is also worth remembering that how high a temperature is bears absolutely no relationship to how serious is the underlying infection. A child dying of meningitis may have a temperature of 38`C whilst the next kid with the Flu may have a temp of 41`C. Do not be foolted into thinking that just a slight rise in temperature means there is nothing much wrong, or equally that a very high fever means your child is at death's door. We wouldn't want life to be that simple would we!
Taking the temperature.
This sounds simple enough, however it is suprisingly easy to get an inaccurate temperature measurement. What you need to measure is the "core temperature" of the body. Not the skin or outer temperature. This is not always as easy as you might think. There a number of ways that the temperature can be measured.
- The gold standard temperature against which other metods are compared, is the rectal temperarure. A rectal thermometer goes far enough inside to be measuring the core temperature. However, not many people, and certainly not many kids, think much of the idea of having a thermometer pushed up their bum!! It is actually totally painful, in fact the thermometer is so slim that you cant actually feel it at all. The indignity and general unpleasantness is enough to put most off.
- Electronic thermometers use heat radiated from the ear-drum to calculate core temperature. These are very simple to use and accurate so long as the ear is not blocked with wax. This is now the method of choice for hospitals and most other Doctors. The machine is simple to use and uses a cheap disposable cover that actually goes into the ear. So there is no issue of sterilising the thermometer in between patients.
- Under the tongue. A thermometer properly located under the tongue and left for at least two minutes will give a good reasonably accurate measurement. The draw-back is that unless disposable covers are used the thermometer must be cleaned and sterilised between each measurement. Also it is unsuitable for young children as the thermometer needs to be made from glass and contains mercury. Should the child bite the thermometer, not only will he probably get a nasty cut in his mouth, he will anso get the mercury in his mouth. Mercury is not known for its health giving properties when swallowed !!
- Under the arm. In the absence of an ear thermometer this can be the only practical way of measuring the temperature in small children.However it is not very accurate. When done with care it should be possible to get reasonably consistent readings, but about 1`C needs to be added to approximate to the core temperature.
Fevers and Temperatures
