发热

发热是指口温超过37.5℃ 或肛温超过38℃。 发热有助于身体抵抗感染，是抵抗力健全的表现。 发热不是疾病，是疾病的一个症状。感冒是发热最常见的原因。 降温的主要目的是使病人减少痛苦，与病情的改善或治疗没有相关性。

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症状

发热会引起寒战。 当炎症或其它病因使大脑的温度计指针上调，身体会相应的产生寒战从而升高体温。 当病情好转或服用退烧药使体温下降时，身体便开始出汗从而降温。

诊断

用手触摸身体的方法来判断是否发热常常有误差。 最准确的测量小儿发热的方法是肛温。 四岁以上的孩子如果配合可以用口温的方法来测试。

肛温＞38℃ 或口温＞37.5℃是发热。

在家如何护理

如果孩子有低温， 没有明显不适感，精神还好，则无需降温。 记住降温只能使孩子舒适一些，对病情的改善或治疗没有帮助。

如果孩子有高温，明显不适，则需要降温来帮助孩子舒服一些。 药物降温为主，物理降温作用不大，而且会使孩子更不舒服，所以尽量不用。

药物降温可用美林或泰诺林。 美林剂量：10mg／公斤体重／次， 每6~8个小时可服用一次， 一天不超过四次。 泰诺林剂量：10~15mg／公斤体重／次， 每4~6小时可服用一次， 一天不超过五次。

美国儿科医学学会强调：药物降温可以使用美林或泰诺林，但不建议交替使用，或同时使用两者， 也不建议同时服用含有美林或泰诺林的感冒药。 否则有造成药物中毒的危险。

注意给孩子补充水分。 发热使体内的水分过分蒸发，所以需要额外补充液体。脱水不仅使病情加重而且不易降低体温。

注意观察孩子的病情变化，如精神状态，是否有兴趣玩耍，是否烦躁或乏力，是否咳嗽剧烈或有呼吸困难，新出现的皮疹，等等。 这些症状的出现有时比发热更重要。

不要把孩子包裹的很严或过分保暖。 不易降温，而且使孩子更不舒服。

以下症状需要去儿科医生处就诊或去急诊室就医：

•    小于3个月的婴儿，肛温大于38℃。
•    大于3个月的婴儿，发热超过2~3天 或体温高达39℃。
•    精神状态不好，有病态。
•    烦躁，过分哭闹。
•    持续呕吐或腹泻，有脱水症状。
•    持续或剧烈头疼，脖子僵硬或疼痛。
•    剧烈咳嗽，呼吸困难。
•    揪耳朵，或有其它症状提示孩子有耳痛。
•    出现新的皮疹。

Fever

Fever is a temperature greater than 99.5° F or 37.5° C orally or 100.4° F or 38° C rectally . Fever helps the body fight infections. It means that the body's defense systems are working hard. Fever is not a disease, rather a symptom. The most common cause for fever is the common cold.

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SYMPTOMS

A fever can cause a chill. When a cause for fever such as a viral infection raises the body's "thermostat," at the brain, the body responds by shivering. Therefore it raises the body's temperature since shivering produces heat. When the temperature goes up, the child often feels warm and some discomfort. When the fever goes down or goes away, the child may start to sweat.

DIAGNOSIS

Tactile temperature is often not accurate. Ear thermometer or temporal thermometer is often not accurate either. The best way is to take the temperature in the rectum for young children or by mouth for older children who can cooperate with holding the thermometer under the tongue with a closed mouth.

HOME CARE INSTRUCTIONS

Remember the main purpose of reducing a fever is to help make your child feel better. It does not improve or treat the disease. Therefore, a mild fever or moderate fever that doesn’t make your child very uncomfortable may not require treatment.

Only give your child Tylenol or Motrin for pain, discomfort, or fever as directed by your doctor. Use either Tylenol or Motrin but not both. The dosage: Tylenol: 10-15mg/kg, every 4-6 hours as needed, not exceeding more than 5 times/day. Motrin: 10mg/kg, every 6-8 hours as needed, not exceeding more than 4 times/day. According to American Academy of Pediatrics, alternating or combining Tylenol and Motrin, or using additional OTC cold medicines that contain Tylenol or Motrin, may increase the risk of overdosing on these analgesics.

Do not over-bundle children in blankets or heavy clothes.

Offer your child more fluids because fever causes the body lose more water.

GO TO YOUR PEDIATRICIAN OR SEEK IMMEDIATE MEDICAL CARE IF:

Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

Your child becomes fussy, irritable or floppy.

Your child develops a rash, a stiff neck, or severe headache.

Your child develops severe abdominal pain, persistent or severe vomiting or diarrhea, or signs of dehydration.

Your child develops a severe or productive cough, or shortness of breath.

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