An increase in body temperature is not a separate disease, but a sign (symptom) of any disease or physiological process. According to experts, in 60% of cases, an ambulance is called home due to a fever. While many doctors say it is not necessary to lower the fever, others say it is necessary to lower the fever so that the child feels better.
Keeping the body temperature constant, that is, fever homeostasis, is accompanied by heat production and heat release. Body temperature is controlled by the brain (through the anterior and posterior parts of the hypothalamic region). Heat production is caused by the excitation of the neuroendocrine system in the presence of the thyroid and adrenal glands (adipose tissue, muscle and liver). Body temperature is constantly maintained in the internal organs. If the temperature under the armpit is 10C lower than the internal organs, the temperature in the rectum is 1-0,80C higher than under the armpit.
Body temperature fluctuates throughout the day (morning and evening), and most children may experience a slight increase in temperature when crying, exercising, or eating. Therefore, it is advisable to measure the child's body temperature 30 minutes after calming down and after eating to get accurate information.
How to measure?
Abroad, children's body temperature is measured through the oral cavity and rectum. The thermometer is lubricated with Vaseline and inserted 2 cm into the rectum and held for at least 3 minutes. In this case, the child should stand with his knees on his feet.
It should be noted that measuring body temperature in the mouth and rectum is a rare method, especially in infants, as it prevents the baby from crying and moving, and the child may break the thermometer if he moves too fast. Given the possibility of such discomfort, it is often recommended to measure the temperature under the armpit. In children over 4 years of age, it is more convenient to measure body temperature in the oral cavity.
It is safe to use unbreakable plastic thermometers instead of glass thermometers. When using any thermometer, the child should be calm, otherwise movement and excitement may change the body temperature.
Normal body temperature is up to 370C. In newborns, the body temperature may be around 1-2C for the first 37,2-37,30 months, which is a physiological condition ("physiological fever") that occurs during the period of adaptation to the environment, in which case the child develops symptoms (ie discomfort). , rapid heartbeat, dehydration) are not observed.
A slight rise in body temperature during infancy does not require any treatment or antipyretic measures, only the child's condition should be monitored for a few days, and the body temperature gradually returns to normal. Observations in medical practice show that parents (even some doctors) sometimes do not pay enough attention to this situation, so we have seen that babies are given antipyretic drugs and hospitalized with various diagnoses.
Pyrogenic, endogenous, exogenous…
Rising body temperatures are often caused by non-infectious and infectious factors.
Non-infectious, ie internal causes of fever include frequent immune system disorders, allergic diseases, tumors, intracranial injuries, cerebral hemorrhage, post-injection pus, medication (interferon, amphotericin, pyrogen), endocrine (bullous) and hereditary diseases are the leading factors.
Occasionally, non-infectious temperatures can rise due to external influences (heat and sunstroke, extreme physical activity) due to a lack of heat release in the body. The high non-infectious temperature rise caused by internal effects occurs after snake bites, improper blood and blood transfusions, heat burns, drug and pesticide poisoning, and metabolic disorders.
Any infection (bacterial, viral, mycoplasmal, chlamydial, parasitic, fungal and vaccines, as well as whooping cough, influenza, typhoid, dysentery, measles) can cause fever. Substances that increase the temperature of the body from the outside or from the inside are called pyrogens (pyrogens - "fire, heat"). Pyrogens come in both exogenous and endogenous forms.
Exogenous pyrogens include endotoxins of gram-negative bacteria, diphtheria bacillus exotoxin, dysentery, and typhoid bacillus protein. At the same time, viruses enhance the synthesis of endogenous pyrogens.
A rise in body temperature above 390C increases the tissues' need for oxygen, which speeds up the cardiovascular and respiratory systems. This results in tissue hypoxia and metabolic changes. Infectious hyperthermia in young children often causes seizures.
White temperature and red temperature
Depending on the characteristics of the child, the body temperature when he is sick will vary. In "red temperature" (the balance between heat production and release in the body), a child's skin is red, hot, slightly wet, and the heart rate and respiration rate vary with temperature. The limbs first cool down and then become hot.
"White temperature" (hyperthermic state) is caused by poisoning, the balance between heat production and release in the body is disturbed, ie heat production prevails and blood circulation is disturbed, peripheral blood vessels constrict, and the acidic environment in the blood increases. Patients show symptoms of chills, chills. The skin is white, marbled, the lips are blue, and the feet are cold. White fever, a hyperthermic heartbeat and shortness of breath, as well as shortness of breath, are accompanied by nausea, convulsions, bruising of the lips and fingernails, and a "white spot."
Antipyretic drugs do not work at "white temperature", that is, high temperatures are very dangerous for the child's health and can lead to various complications.
At the same time, the body loses a lot of energy and water. This, in turn, causes the blood to clot and disrupt blood circulation to other organs in the small blood vessels (mainly the capillaries), resulting in fluid leaking out of the blood vessels, causing swelling and dripping blood in the brain.
Therefore, in case of high fever, it is necessary to provide timely first aid. Otherwise, profound changes in the nerves, heart, and other organs due to a high fever can be very dangerous for the child's life. In this case, the child's life can be saved, but it should be borne in mind that the patient may become mentally disabled as a result of brain dysfunction.
Benefits of "Tea Treatment"
Most children do not have a high fever. Therefore, given that the body naturally fights the infectious process, it is important not to rush to reduce the fever with medication. In such cases, following the rules of observation, care and feeding of the child gives good results.
Follow these tips:
Initially, the child becomes cold and has a fever, in which case the child should be wrapped in a warm bed and given warm liquids (hot tea, compote, fruit juices).
At the "red temperature" undress the child, drink more fluids. This is because the baby loses a lot of fluid through the skin and airways.
If fever is accompanied by symptoms of vomiting and diarrhea, use the "tea treatment" method we suggest. To do this, the room temperature should be 28-300C and the doors and windows of the house should be closed. It is not necessary to heat the room temperature on hot summer days. The child is stripped naked, and the tea tincture (green tea) in the bowl should be hot. The baby's hands and feet, then the body, armpits and groin, neck and head and face are washed repeatedly with hot tea. As the child has a fever, the skin dries quickly, so it is enough to wipe the head with a towel. After that, the child is lightly dressed and warm tea is drunk.
In general, you can use the "tea treatment" several times a day for a child with a fever. Because tea replaces antipyretics. So what are the benefits of green tea in reducing fever?
Tea is quickly absorbed into the skin when hot, dilates blood vessels and provides heat dissipation. Caffeine in tea is absorbed through the skin and has a positive effect on the cardiovascular system. Bathing with tea and drinking tea satisfies and calms the child's need for fluids. The baby falls asleep peacefully in front of your eyes, which leads to a normalization of body temperature.
Many parents wipe the body of a child with a fever with vodka or alcohol. When alcohol is used, the child's skin burns, the skin becomes dry, and alcohol can be absorbed into the bloodstream through the skin and cause toxic effects.
Give medicine if necessary
When fever poses a health risk, medications are used to lower the temperature. For example, regardless of the age of the child, if the body temperature is above 390C, "white temperature" or hyperthermia occurs, the temperature rises in severe diseases of the respiratory, cardiovascular, nervous and other organs, in children under 5 years of age with previous seizures. In children under 2 months of age (because infants of this age are less able to cope with fever than adults).
Conditions that can worsen the child's condition, such as headaches and muscle aches, irritability, postprandial vomiting, and seizures, may be treated with antipyretics. In pediatric practice, analgin is sometimes used as an antipyretic and analgesic (ie, if the child is unable to tolerate paracetamol and ibuprofen).
It is not possible to recommend antipyretic drugs for a long time without determining the cause of the disease. Continuous use of antipyretic drugs in combination with antibacterial drugs has not been proven. In white fever (hyperthermia), the use of vasodilators (papaverine) and antihistamines (pipolfen) in combination with antipyretics is effective.
In case of hyperthermic syndrome and the absence of antipyretic drugs for 2 days, the child should be hospitalized. It is important to keep in mind that long-term use of antipyretic drugs by a child and that mothers use different antipyretics on their own and do not seek medical attention in a timely manner can lead to various complications.
Thus, only safe antipyretic drugs should be used in children, such as paracetamol and ibuprofen. Antipyretics are recommended for healthy children when the fever is uncomplicated and the body temperature exceeds 39-39,5 ° C. Antipyretic drugs should not be used in non-infectious fevers (central, neurohumoral, refractory type, due to metabolic disorders, after medication).
Saydullo RASULOV,
pediatrician, doctor of medical sciences.
