Managing high fever at home

Few days ago at around 1 a.m., one worried and anxious mother called me on my cell phone seeking emergency medical advice for her four year old son. Her little child suddenly developed high fever and temperature measured was 1050F. The mother did not know what to do right away at home.
To lower the temperature rapidly, I advised her to give her child one Paracetamol suppository (a missile shaped capsule that is inserted into the rectum). 20 minutes later, she called me again. The temperature did not fall. Hospital was far away from her home. Moreover, she had no personal transport to reach at hospital in this late night.
I advised her not to be panicked and to remove all the clothes of the child and start sponging whole body with tepid water. After 20 minutes, she rang me again as there was no drop of temperature yet. I asked her, is there any convulsion? She replied no. The child was well alert. Then I told her to put the baby under shower for few minutes and make him dry with towel and keep him under fan. About half an hour later, she called me with a sigh of relieve. Her child was much better and temperature had come down to 1010F. I recommended her to give him some fluid to drink, especially oral saline and bring the child to me in the morning.
In the next morning, when the mother came to me, I took the thorough history and examined the child carefully and meticulously. There was no sign of serious infection like meningitis (brain infection). Actually, the boy had tonsillitis that caused the fever. Tonsillitis is a common infection in children that causes sore throat, fever, swollen glands in the neck and trouble swallowing.
I assured the mother, prescribed oral antibiotic and advised her to come back after two days if the symptoms did not improve. This scenario is not very uncommon in our daily practice. So, tepid water sponging and giving Paracetamol orally or suppository into the rectum is the ideal treatment for high temperature.
It is always better to avoid Diclofenac suppository (a painkiller drug which is wrongly practiced in management of fever in some cases), as it may deteriorate the condition if it is a dengue fever. The most important role of a physician is to exclude any serious life threatening condition that cause fever like meningitis, dengue with bleeding manifestation etc.
If you have a child under five years of old, keep some Paracetamol syrup and suppository for emergency purpose. Don't panic and do what we did for in case of the above child. Keep in touch with your physician. Take care of your child.

The writer is a Paediatrician working at Community Based Medical College (CBMC), Mymensingh.
E-mail: [email protected]