Fever in children

Question 1

What counts as a high-grade fever in children?

Answer 1

Temperature above 38C

• normal = 37
• high-grade = 39

Question 2

Associative symptoms in fever in children

Answer 2

Feel hotter than usual when touching forehead, back or stomach
Sweaty and clammy
Flushed cheeks

Question 3

When to refer children?

<3months
3-6 months

> 6months

Answer 3

< 3 months
38C +

3-6 months
39C, 24 hours

6 months+
72 hours

• dehydration
• febrile convulsions
• serious signs: floppiness, drowsiness, persistent crying?, vomiting, rash or seizures

Question 4

Paracetamol for children

• Strength
• Age + weight requirements

Answer 4

120mg/5ml

2 months+
4kg +

Question 5

Paracetamol for children - dosing for fever etc.

3-6 months
6-24 months
2-4 years
4-6 years

2-3 months, 4kg +, born after ? weeks? Give second (?) dose.

Answer 5

QDS - 4 hours between each dose

3-6 months = 60mg (2.5 ml)
6-24 months = 120mg (5ml)
2-4 years = 180mg (7.5ml)
4-6 years = 240mg (10ml)

2-3 months, 4kg+, born after 37 weeks, give second 2.5ml dose

Question 6

Paracetamol for children dosing for

• Post immunisation
• post immunisation of meningitis B

Answer 6

• 2-4 months 60mg dose, up to QDS at time of vaccination

- Men B - 60mg dose, then 60mg after 4-6 hours, then 60mg after 4-6 hours (unlicensed)

Question 7

Ibuprofen for children
Strength
Age + weight requirement

Answer 7

100mg/5ml

3 months+
Over 5kg

Question 8

Paracetamol dosing for children:
60mg
120mg
180mg
240mg

Answer 8

3-6 months = 60mg (2.5 ml)
6-24 months = 120mg (5ml)
2-4 years = 180mg (7.5ml)
4-6 years = 240mg (10ml)

Question 9

Ibuprofen dosing for children

3-6 months 
6-12 months
1-3 years 
4-6 years
7-9 years

Answer 9

Take TDS - 6-8 hours between doses (minimum 4 hours)

3-6 months = 50mg (2.5mL)
6-12 months = 50mg TDS/QDS
1-3 years = 100mg (5ml)
4-6 years = 150mg (7.5ml)
7-9 years = 200mg (10ml)

Question 10

Ibuprofen dosing for children:

50mg (2.5mL)
50mg TDS/QDS
100mg (5ml)
150mg (7.5ml)
200mg (10ml)

Answer 10

3-6 months = 50mg (2.5mL)
6-12 months = 50mg TDS/QDS
1-3 years = 100mg (5ml)
4-6 years = 150mg (7.5ml)
7-9 years = 200mg (10mL)

Question 11

Ibuprofen for children - post immunisation

Answer 11

At 2,3 months - 50mg dose followed by ONE further 50mg dose 6 hours later if required

Question 12

Advice for fever in children

Answer 12

Keep child hydrated
- Look out for signs of dehydrations - dry mouth, no tears, sunken eyes, fewer wet nappies

Use digital thermometer

• Most accurate way to measure temperature
• Under armpit if under 5
• ear
• rectum
• mouth (under tongue)