OTC - fever in children

Question 1

Symptoms?

Answer 1

• high temp above 38 degrees
• high grade is >39

Associated symtpoms

• feel hotter than usual when touching forehead, back or stomach
• sweaty and clammy
• flushed cheeks

Question 2

Referral criteria?

Answer 2

Temp

• < 3month old >/=38
• 3-6 month old >/=39

Duration

• > 24 hours 3-6 months
• > 72 hours in >6 months
• dehydration
• febrile convulsions
• serious signs: floppiness, drowsiness, persistent vomiting, rash or seizures

Question 3

OTC products

Answer 3

Paracetamol/ibuprofen

Question 4

When can paracetamol 120mg/5ml be used?

Answer 4

• 2 months +

- over 4kg

Question 5

Paracetamol dose for 3-6 months? (120mg/5ml)

Answer 5

60mg (2.5ml) QDS

Question 6

Paracetamol dose for 6-24 month? (120mg/5ml)

Answer 6

120mg (5ml) QDS

Question 7

Paracetamol dose for 2-4 year old? (120mg/5ml)

Answer 7

180mg (7.5ml) QDS

Question 8

Paracetamol dose for 4-6 years? (120mg/5ml)

Answer 8

240mg (10mls) QDS

Question 9

Paracetamol dose for 6-8 years? (250mg/5ml)

Answer 9

250mg (5ml) QDS

Question 10

Paracetamol dose for 8-10 years? (250mg/5ml)

Answer 10

375mg (7.5mls) QDS

Question 11

Paracetamol dose for 10-12 years? (250mg/5ml)

Answer 11

500mg (10mls) QDS

Question 12

Paracetamol dose for 12-16 years old? (250mg/5ml)

Answer 12

500mg-750mg (10-15mls) QDS

Question 13

Paracetamol dose in adults and children over 16yrs (250mg/5ml)?

Answer 13

500mg-1000mg (10-20ml) up to QDS

Question 14

Paracetamol dose in 2-3 months, 4kg+ and born after 37 weeks? (120mg/5ml)

Answer 14

60mg (2.5ml), if necessary, after 4-6 hours, give second 2.5ml dose

Question 15

Post immunisation paracetamol dose in 2, 3 and 4 months for paracetamol 120mg/5ml?

Answer 15

• at 2,3 & 4 months 60mg dose up to 4 times a day at the time of vaccination
• meningitis B: 60mg dose, then 60mg after 4-6 hours, then 60mg after 4-6 hours (unlicensed)

Question 16

When can ibuprofen 100mg/5ml be used?

Answer 16

• 3 months +

- over 5kg

Question 17

Ibuprofen dose for 3-6 months? (100mg/5ml)

Answer 17

50mg (2.5ml) TDS

Question 18

Ibuprofen dose 6-12 months? (100mg/5ml)

Answer 18

50mg (2.5ml) 3 or 4 times a day

Question 19

Ibuprofren dose 1-3 years? (100mg/5ml)

Answer 19

100mg (5ml) TDS

Question 20

Ibuprofen dose 4-6 years? (100mg/5ml)

Answer 20

150mg (7.5ml) TDS

Question 21

Ibuprofen dose 7-9 years (100mg/5ml)?

Answer 21

200mg (10ml) TDS

Question 22

Ibuprofen dose 10-12 years (200mg/5ml)

Answer 22

300mg (7.5mls) TDS

Question 23

Post immunisation ibuprofen dose? 100mg/5ml

Answer 23

At 2,3 months 50mg (2.5ml) followed by one further 2.5mls 6 hours later if required

Question 24

Advice in fever?

Answer 24

• keep child hydrated: look out for signs of dehydration - dry mouth, no tears, sunken eyes, in babier - fewer wet nappies
• use digital thermometer (most accurate way to measure temperature)
  
  • under armpit (if under 5)
  • ear
  • rectum
  • mouth (under the tongue)