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Facts about heat, you need to know!

Факты о высокой температуре, это необходимо знать!

Body temperature is a complex indicator of the thermal state of the animal organism, including humans. It is one of the main and oldest biomarkers. Animals that are able to maintain their temperature in a narrow range regardless of the temperature of the external environment are called warm-blooded, or homeothermic. Warm-blooded animals include mammals and birds. Animals deprived of this ability are called cold-blooded, or poikilothermic. Maintaining body temperature by the body is called thermoregulation. In cold-blooded animals, body temperature differs little from the ambient temperature, and only with intensive muscular activity in some species can it significantly exceed the ambient temperature.

Fever (Latin febris) is a nonspecific typical pathological process characterized by a temporary increase in body temperature due to the dynamic adjustment of the thermoregulation system under the action of pyrogens (substances that cause an increase in temperature). In evolution, fever arose as a protective and adaptive reaction to an infection of the body of higher animals and humans, therefore, in addition to an increase in body temperature during this process, other phenomena characteristic of infectious pathology are also observed. Usually fever is accompanied by bouts of heat. In the past, all diseases accompanied by a rise in body temperature were called “fever”, but in the modern scientific understanding, fever is not a disease. At the same time, in the modern names of a number of nosological units, the term fever is present, for example, Rocky Mountain spotted fever, Pappatachi fever, Ebola hemorrhagic fever, etc. The essence of the fever is such a response of the thermoregulation apparatus of higher homoothermic animals and humans to specific substances (pyrogens) characterized by a temporary shift in the set point of temperature homeostasis to a higher level, with the mandatory preservation of the mechanisms of thermoregulation themselves, which is the principle pial difference of fever from hyperthermia.

When you go to the doctor to report an illness, the first question he always asks is: “Was the temperature measured? What is the temperature? " And further, no matter what answers you give him - 38 or 40 degrees, he advises you to give simple aspirin and bring it to him for an appointment. It has become a ritual of almost all pediatricians in our country. Surely, many of them speak only memorized phrases, even if they hear about a temperature of 43 degrees.

My concern is that children's doctors ask the wrong questions and give the wrong advice. Doctors see something extremely dangerous in raising the temperature, otherwise why is it their first concern? And from their advice to give the child aspirin, parents inevitably conclude that treatment should be medication and aimed at lowering the temperature.

By measuring body temperature and recording its indicators on a medical record, admission begins in most children's clinics. There is nothing wrong. An elevated temperature is indeed an important diagnostic symptom in the context of a follow-up examination. The problem is that much more importance is attached to it than it would be worth. When a doctor sees on a map a nurse’s record of a temperature of, say, 39.5 degrees, he invariably says with a grim look: “Wow! Something must be done! ”

His concern about temperature is nonsense, and misleading nonsense! There is no need to do anything with the temperature increase itself. In the absence of additional symptoms, such as unusual behavior, especially weakness, difficulty breathing, and others suggesting serious illnesses like diphtheria and meningitis, the doctor should tell parents that there is nothing to worry about and send them home with the child.

Taking into account the exaggerated attention of doctors to fever, it is not surprising that most parents, according to opinion polls, have great fear of her. Moreover, this fear grows in proportion to the readings of the thermometer, while it is most often groundless.

Here are facts related to body temperature, the knowledge of which will help you to avoid many worries, and your children - unnecessary and dangerous tests, radiological studies and medicines.

Факты о высокой температуре, это необходимо знать!

Each doctor should take these facts into account, but many pediatricians prefer to ignore them and do not consider it necessary to introduce their parents to them.

Fact No. 1.

The temperature of 37 degrees is not "normal" for everyone, as they tell us all our lives. This is simply not true. The established “norm” is very arbitrary, since the indicator of 37 degrees is the average value. Many people have normal temperatures higher or lower. This is especially true for children. Studies have shown that body temperature in most absolutely healthy children is 35.9-37.5 degrees, and only a few - exactly 37 degrees.

Fluctuations in the body temperature of the child during the day can be significant: in the evening it is a whole degree higher than in the morning. If a child has a slightly elevated temperature in the afternoon, do not worry. For this time of day this is quite normal.

Fact No. 2.

The temperature may rise for reasons not related to any disease: during the digestion of heavy and heavy foods or at the time of ovulation in adolescent girls during their puberty. Sometimes a fever is a side effect of the medications prescribed by your doctor - antihistamines and others.

Fact No. 3.

The temperature to be wary of usually has an obvious reason . In most cases, an increase in temperature, which can be a threat to health, occurs either as a result of poisoning with toxic substances, or as a result of overheating (the so-called heat stroke).

Classical examples of overheating are a soldier who faints in a parade, or a marathon runner who goes out of the race and falls from exhaustion in the sun. In such cases, the temperature can rise to 41.5 degrees or higher, which is fraught with harmful consequences for the body. A similar effect can be achieved by overheating excessively in a bath or in a jacuzzi.

If you suspect that a child has swallowed a poisonous substance , call the poisoning help center immediately. When this is not possible, without waiting for trouble, urgently take the child to the hospital and, if possible, grab the packaging from the swallowed product - this will help to quickly find the antidote.

As a rule, substances swallowed by children turn out to be relatively harmless, but timely seeking help is very important.

Immediate flow is also necessary if the child loses consciousness, even if only briefly, after outdoor games in the heat or after a bath or jacuzzi. Calling a doctor in this situation is not enough. Take the child to the hospital as soon as possible. External influences are potentially dangerous. They are able to suppress the body's defenses, which under normal conditions do not allow the temperature to rise to a dangerous level. These events and their associated symptoms help to recognize such conditions. I emphasize: loss of consciousness means that the child is in danger.

Fact No. 4.

Indications of body temperature depend on the method of measuring it . Rectal (in the rectum) temperature in children is usually one degree higher than oral (in the mouth), axillary - one degree lower. However, in infants, the difference between the temperature values ​​measured by these methods is not so great, therefore, it is better for them to measure the temperature in the armpit.

I do not recommend using a rectal thermometer: with its introduction, perforation of the rectum is possible, and it is fatal in half the cases. Why take risks when this is not necessary? Finally, do not think that the temperature of the baby’s body can be determined by touch by touching the forehead or chest. Neither the medical staff nor you will succeed.

Fact No. 5.

It is not necessary to bring down body temperature . The only exceptions are newborns suffering from infections, which are often caused by obstetric interventions during childbirth, intrauterine and hereditary diseases. An acute contagious disease can result from some procedures. For example, an abscess under the scalp can develop in an infant from the sensors of the device during prenatal monitoring, and aspiration pneumonia due to amniotic fluid that has entered the lungs as a result of the mother's administration during the delivery of drugs. Infection is also possible during the circumcision procedure: in hospitals there are legions of pathogens (this is just one of the reasons my grandchildren were born at home). If the baby rises in the first months of life, it is absolutely necessary to show it to the doctor.

Fact No. 6.

Temperature may rise from over-wrapping . Children are very sensitive to overheating. Parents, especially first-born children, are often overly concerned about whether their children are cold. They wrap the kids in many clothes and blankets, forgetting that if he gets hot, he will not be able to free himself from warm clothes on his own. If the baby has a fever, do not forget to check if he is too warmly dressed.

If a child with a temperature, especially accompanied by chills, is wrapped tightly in thick blankets, this will provoke an even greater rise in it. A simple rule that I recommend to the parents of my patients: let the child have as many layers of clothing as there are on them.

Fact No. 7.

Most cases of fever are associated with viral and bacterial infections , which the body’s defenses cope with without any help. Colds and flu are the most common causes of fever in children of any age. The temperature can rise to 40.5 degrees, but even in this case there is no reason for concern.

The only danger is the risk of dehydration from concomitant sweating, rapid heart rate and breathing, coughing, vomiting and diarrhea. It can be avoided by giving the child a plentiful drink. It would be nice if the child drank every hour a glass of liquid, preferably nutritious. It can be fruit juice, lemonade, tea and everything that the child will not refuse. In most cases, viral and bacterial infections are easily recognized by the symptoms that accompany the fever: mild cough, runny nose, watery eyes, and so on. With these diseases, neither the help of a doctor nor any medicine is needed. The doctor will not be able to "prescribe" anything more effective than the body's defenses. Medicines that alleviate the general condition, only interfere with the action of vitality. I will talk about this in more detail in one of the following chapters.

Antibiotics are not needed either: although they can shorten the duration of a bacterial infection, the risk associated with them is very high.

Fact No. 8.

There is no unambiguous connection between the temperature of the child’s body and the severity of the disease . A common misconception about this is unjustified. In addition, there is no consensus on what is considered “high fever” among parents, or even among doctors. The parents of my patients, and I had a lot of them, had diametrically opposite views on this score. Studies have shown that more than half of the parents surveyed consider the temperature from 37.7 to 38.8 degrees “high” and almost all call the temperature 39.5 degrees “very high”. In addition, all respondents were convinced that high fever indicates the severity of the disease.

It's not like that at all. More precisely, by the hour, the measured temperature absolutely does not say anything about the severity of the disease if it is caused by a viral or bacterial infection. Once you understand that the cause of the temperature is infection, stop measuring the temperature hourly. Tracking its increase in such a disease will not help, moreover, it will only increase your fears and tire the child.

Some common, non-dangerous diseases, like one-day measles, sometimes cause a very high temperature in children, while others, more serious, can occur without an increase in it. If there are no additional symptoms such as vomiting or difficulty breathing, keep calm. Even if the temperature rises to 40.5 degrees.

To determine whether the illness is caused by a mild, like a cold, or a serious, like meningitis, temperature, it is important to consider the general condition of the child, his behavior and appearance. You will appreciate all these points much better than the doctor. You know much better how your child usually looks and how he behaves. If there is unusual lethargy, confusion and other alarming symptoms that last a day or two, it makes sense to call a doctor. If the child is active, has not changed his behavior, there is no reason to fear that he is seriously ill.

From time to time, pediatric magazines come up with articles on “temperature-phobia,” an unreasonable parental fear of fever in children. Doctors specially invented this term - a typical tactic of “accusing a victim” for people of my profession: doctors never make mistakes, and if mistakes occur, patients are to blame. In my opinion, “temperaurophobia” is an affliction of pediatricians, not parents. And it is the doctors who are to blame for the fact that parents become its victims.

Fact No. 9.

The temperature caused by a viral or bacterial infection, if not knocked down, will not rise above 41 degrees. Pediatricians do a poor job prescribing antipyretics. As a result of their appointments, the anxiety of parents that the temperature can rise to the extreme limit, if measures are not taken, is reinforced and intensified. Doctors do not say that knocking down the temperature does not affect the healing process, nor does the human body have a mechanism (not yet fully explained) that prevents the temperature from breaking the 41 degree barrier.

Only with thermal shock, poisoning and other external influences, this natural mechanism may not work. It is in such cases that the temperature rises above 41 degrees. Doctors know this, but most of them pretend they don’t know. I believe that their behavior is caused by a desire to demonstrate their help to the child. In addition, there is a general desire for doctors to intervene in any situation and a reluctance to recognize that there are conditions that they are not able to treat effectively. In addition to cases of fatal, incurable diseases, which doctor decides to tell the patient: “I can’t do anything” ?

Fact No. 10.

Measures to reduce the temperature, whether using antipyretics or rubbing with water, are not only unnecessary, but also harmful . If the child is infected, then the increase in temperature that accompanies the course of the disease, parents should not perceive as a curse, but as a blessing. Temperature rises as a result of spontaneous production of pyrogens - substances that cause fever. This is the body’s natural defense against disease. An increase in temperature indicates that the body’s healing system has turned on and is working.

The process develops as follows: the child's body responds to an infectious disease by producing additional white blood cells - white blood cells. They kill bacteria and viruses and cleanse the body of damaged tissues and decay products. The activity of leukocytes increases while they quickly move to the site of infection. This part of the process, the so-called leukotaxis, is precisely stimulated by the production of pyrogens that increase body temperature. An elevated temperature indicates that the healing process is accelerating. This should not be afraid, this should be rejoiced.

But that's not all. Iron, which serves as a food source for many bacteria, leaves the bloodstream and accumulates in the liver. This reduces the rate of bacterial reproduction and increases the effectiveness of interferon produced by the body to fight the disease.

This process was demonstrated by scientists in laboratory experiments on infected animals. With an artificial increase in temperature, the mortality of experimental animals from infection decreased, and with a decrease, it increased. An artificial increase in body temperature has long been used in cases where the patient’s body has lost its natural ability in diseases.

If the child’s temperature rises as a result of infection, do not give in to the desire to knock it down with medication or rubdown. Let the temperature do the trick. Well, if your compassion requires you to alleviate the condition of the patient, give the child a paracetamol dosage appropriate for the age or wipe the body with warm water. This is quite enough. A doctor is needed only when the temperature lasts more than three days, other symptoms appear, or the child is completely ill.

I emphasize: lowering the temperature to alleviate the condition of the child, you interfere with the natural healing process. The only reason that forces me to talk about ways to lower the temperature is the knowledge that some parents are unable to resist this.

If you can’t keep the temperature down, wiping with water is preferable to taking aspirin and paracetamol because of their danger. Despite the popularity, these funds are far from harmless. Aspirin poisons annually, possibly more children than any other poison. This is the same form of salicylic acid that is used as the basis of the anticoagulant in rat poisons - rats, eating it, die from internal bleeding.

Aspirin can cause a number of side effects in children and adults. One of them is intestinal bleeding. If children receive this medication during a period of flu or chickenpox illness, they may also develop Reye's syndrome, a common cause of infant mortality, mainly due to exposure to the brain and liver. This is partly why many doctors switched from aspirin to paracetamol ( acetaminophen, panadol, calpol and others ).

Reception of this tool is also not a way out. There is evidence that large doses of this drug are toxic to the liver and kidneys. Let me also draw your attention to the fact that children whose mothers took aspirin during childbirth often suffer from cephalohematomas , a condition in which cones filled with fluid appear on the head.

If you still decide to lower the body temperature of the child by rubbing, use only warm water. A decrease in body temperature is achieved by evaporation of water from the skin and is independent of water temperature. That is why too cold water has no advantages. Alcohol is not suitable for rubbing: its vapors are toxic for the baby.

Fact No. 11.

High temperature caused by a viral or bacterial infection does not lead to brain damage and does not cause other negative consequences. The fear of high temperature comes largely from the widespread belief that it can lead to irreversible damage to the brain or other organs. If this were so, the panic of the parents with a rise in temperature would be justified. But, as I said, the statement is false.

Those who are familiar with this fear, I advise you to forget about everything that has sowed it, and never take on faith the words about such a threat of high temperature, from whoever they come from other parents, the elderly or a friend of the doctor who gives advice in a friendly manner a cup of coffee. And even if such advice was given by the all-knowing grandmother. Alas, it is not always right. Colds, flu and any other infection will not raise the child’s body temperature above 41 degrees, and a temperature below this level will not cause long-term harm.

Every time you do not need to expose yourself to fear of a possible brain damage in a child with an increase in his temperature: the body's defenses will not allow the temperature to rise above 41 degrees. I do not think that even pediatricians who have been practicing for decades have seen more than one or two cases with high fever. A rise in temperature above 41 degrees is not caused by infection, but by poisoning or overheating. I treated tens of thousands of children and only once observed in my patient a temperature above 41 degrees. This is not surprising. Studies have shown that in 95 percent of cases of fever in children, it did not rise above 40.5 degrees.

Fact No. 12.

High temperature does not cause cramps. They are caused by a sharp rise in temperature. Many parents are afraid of the high temperature of their children, because they noticed that she is accompanied by bouts of seizures. They think cramps are caused by "too high" temperatures. I well understand such parents: a child in convulsions is an unbearable sight. Those who observed this may find it difficult to believe that, as a rule, this condition is not serious. In addition, it is relatively rare - only 4 percent of children with high fever have cramps, and there is no evidence that they leave serious consequences.

A study of 1,706 children who experienced febrile seizures did not detect any motor impairment and did not record fatal outcomes. There is also no convincing evidence that such convulsions subsequently increase the risk of epilepsy.

Moreover, measures to prevent febrile seizures - taking antipyretic drugs and rubbing - are almost always carried out too late and, therefore, in vain: by the time a child has high fever, most often, the seizure threshold has already been passed. As I already said, cramps do not depend on the temperature level, but on the speed of its rise to a high point. If the temperature has risen sharply, convulsions have either already occurred, or their danger has passed, that is, it is almost impossible to prevent them.

Children under five years of age are usually prone to febrile seizures. Children who experience such cramps at this age subsequently rarely suffer from them. To prevent the recurrence of seizures at high temperatures, many doctors prescribe children with long-term treatment with phenobarbital and other anticonvulsants. If such a prescription is prescribed for your child, ask your doctor about the risks associated with them and what changes in their behavior they lead to.

In general, there is no unanimity among doctors regarding the long-term treatment of febrile seizures. Medications, which are usually used in this case, cause liver damage and even, as shown by experiments on animals, adversely affect the brain. One of the authorities on this issue once remarked: “Sometimes it is more beneficial for a patient to live a normal life between episodes of seizures than to live on drugs without seizures, but in a constant state of drowsiness and confusion ...”

I was taught to prescribe children with febrile seizures (to prevent their recurrence) phenobarbital, current medical students are taught the same thing. I doubted the correctness of the prescription of this drug when I noticed that during treatment with it, in some patients, convulsions recur. This, of course, made me wonder: did phenobarbital in the remaining patients stop them? My suspicions intensified after the complaints of some mothers that the drug overexcites children or inhibits so much that, usually active and sociable, they suddenly turn into half-zombies. Since the seizures are episodic and do not leave any lasting effects, I stopped prescribing this medicine to my little patients.

If a child with febrile seizures is prescribed a long-term treatment, parents will have to decide whether to agree to it or not. I understand that openly expressing doubts about doctor's prescriptions is not easy. I also know that the doctor may shrug off questions or not give intelligible answers. If this happens, it makes no sense to start a dispute. You must take a prescription from a doctor and, before buying a medicine, ask another doctor for advice.

If your child has a temperature-related cramp, try not to panic. Of course, giving advice is much easier than following it. The sight of a child with cramps is really scary. And yet: remind yourself that cramps do not threaten the life of your baby and will not cause irreversible harm, and take simple measures to ensure that the child does not suffer during an attack.

First of all, turn the child to one side so that he does not choke with saliva. Then make sure that there are no hard and sharp objects near his head that could injure him during the attack. After making sure that nothing prevents the baby’s breathing, place a hard, but not sharp object between his teeth - for example, a clean folded leather glove or wallet (not a finger!) So that he does not accidentally bite his tongue. After that, for your own reassurance, you can call the doctor and talk about what happened.

For the most part, cramps last a few minutes. If they drag out, ask your doctor for advice. If after a seizure attack the child does not fall asleep, it is impossible to give him food and drink for an hour. Due to severe drowsiness, he may choke.

Body temperature quick start guide

High fever is a symptom often found in children that is not associated with serious illnesses (in the absence of other disturbing symptoms, such as unusual appearance and behavior, difficulty breathing and loss of consciousness). It is not an indicator of the severity of the disease.

The temperature that rises as a result of infection does not reach values ​​at which irreversible damage to the organs of the child is possible.

Elevated temperature does not require medical intervention beyond what is recommended below. The temperature does not need to be knocked down. It is a natural defense of the body against infection and helps speedy healing.

one

If the child’s body temperature rises above 37.7 degrees before two months, consult a doctor. This may be a symptom of an infection - intrauterine or associated with interference with the birth process. Elevated temperature in children of this age is so unusual that it is prudent to hedge and rather calm down if the alarm turns out to be false.

2

For children older than two months, a doctor is not needed if the temperature rises, except when the temperature persists for more than three days or is accompanied by serious symptoms - vomiting, shortness of breath, severe coughing for several days and others that are not typical for a cold. Talk to your doctor if your child is unusually lethargic, irritable, distracted, or looks seriously ill.

3

See your doctor regardless of thermometer if the child has difficulty breathing, indomitable vomiting, if the temperature is accompanied by involuntary twitching of muscles or other strange movements or if something else is disturbing in the child’s behavior and appearance.

four

If the temperature rises accompanied by chills, do not try to cope with this sensation of the child with a blanket. This will lead to an even sharper increase in temperature. Chills are not dangerous - this is a normal reaction of the body, a mechanism of adaptation to a higher temperature. It does not mean that the child is cold.

5

Try to put the feverish child to bed, but do not overdo it. There is no need to bed the child and keep him at home if the weather is not too bad. Fresh air and moderate activity will improve your baby’s mood without worsening your condition and make your life easier. However, too intense loads and sports should not be encouraged.

6

If there is reason to suspect that the cause of the fever is not an infection, but other circumstances - overheating or poisoning, take the child to the hospital immediately. If your area does not have an emergency room, use any available medical care.

7

Do not, according to popular tradition, "starve a fever." Nutrition is important for recovering from any disease. If the baby does not counteract, “feed” both colds and fevers. Both those and others burn reserves of proteins, fats and carbohydrates in the body, and they need to be reimbursed. If your child refuses to eat, give him nutritional fluids, such as fruit juice. And don't forget that chicken soup is good for everyone.

High fever and usually accompanying symptoms lead to significant loss of fluid and cause dehydration. It can be avoided by giving the child a lot to drink, fruit juices are best, but if he doesn’t want them, any liquid is suitable, preferably one glass every hour.

Via book by Robert Mendelssohn “How to raise a child healthy in spite of doctors” & wiki.