Facts about heat, you need to know!
Body temperature is a complex indicator of the thermal state of the organism of animals, including humans. It is one of the main and oldest biomarkers. Animals that are able to maintain their temperature in narrow limits, regardless of the temperature of the external environment, are called warm-blooded, or homoiothermal. Warm-blooded animals include mammals and birds. Animals lacking 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 (lat. Febris) is a non-specific type of pathological process, characterized by a temporary increase in body temperature due to the dynamic reorganization of the thermoregulation system under the influence of pyrogens (substances that cause a rise in temperature). In evolution, fever arose as a protective-adaptive response to infection of the organism of higher animals and humans, therefore, in addition to an increase in body temperature, this process also has other phenomena characteristic of infectious pathology. Usually fever is accompanied by bouts of fever. 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. However, 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. characterized by a temporary shift of the set point of temperature homeostasis to a higher level, with the necessary preservation of the mechanisms of thermoregulation, which is the principle pial difference of fever from hyperthermia.
When you go to a doctor to report a disease, the first question he always asks is: “Was the temperature measured? What is the temperature? And further, regardless of what answers you give him - 38 or 40 degrees, advises to give a simple aspirin and bring it to him for an appointment. This has become the 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.
What worries me is that children's doctors ask the wrong questions and give the wrong advice. In raising the temperature, doctors see something extremely dangerous, otherwise why is it their first concern? And from their advice to give the child aspirin, parents inevitably conclude that the treatment should be medical and aimed at reducing the temperature.
The measurement of body temperature and the recording of its indicators in the medical card begins reception 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 it is given much more value than it would be worth. When the doctor sees in the card a nurse's record of a temperature of, say, 39.5 degrees, he invariably says with a gloomy look: “Wow! We need to do something!
His concern about temperature is nonsense, and misleading nonsense! You don't have to do anything with the increase in temperature. In the absence of additional symptoms, such as unusual behavior, particular weakness, difficulty breathing and others, suggesting serious diseases such as diphtheria and meningitis, the doctor should tell the 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, according to opinion polls, the majority of parents have a great fear of her. Moreover, this fear grows in proportion to the readings of the thermometer, while it is most often baseless.
Here are the facts about body temperature, knowledge of which will help you avoid many worries, and your children - unnecessary and dangerous tests, x-rays, and medications.
These facts should be taken into account by every doctor, however many of the pediatricians prefer to ignore them and do not consider it necessary to introduce them to their parents.
Fact number 1.
The temperature of 37 degrees is not “normal” for everyone, as they say to us throughout their lives. This is simply not true. The established “norm” is very conditional, since the indicator of 37 degrees is an average statistical value. A lot of people have a normal temperature higher or lower. This especially applies to children. Research has revealed that the body temperature of the majority of absolutely healthy children is 35.9-37.5 degrees and only a few have 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. Having found a slightly elevated temperature in a child in the afternoon, do not worry. For this time of day it is quite normal.
Fact number 2.
The temperature may rise for reasons not related to any disease: during the digestion of rich and heavy food or at the time of ovulation in adolescent girls during their puberty. Sometimes a rise in temperature is a side effect of the drugs prescribed by the doctor - antihistamines and others.
Fact number 3.
A feared temperature usually has an obvious reason . In most cases, an increase in temperature, which may pose a health risk, occurs either as a result of poisoning by toxic substances, or as a result of overheating (the so-called heat stroke).
The classic examples of overheating are a soldier who loses consciousness in a parade, or a marathon runner descending from a distance and falling from exhaustion in the sun. In such cases, the temperature can rise to 41.5 degrees or higher, which is fraught with disastrous consequences for the body. A similar effect can be achieved and overheated in bath or in the jacuzzi.
If you suspect that a child has swallowed a poisonous substance , immediately call the poisoning assistance center. When this is not possible, without waiting for trouble, immediately take the child to the hospital and, if possible, seize the package from the ingested drug - this will help you quickly find the antidote.
As a rule, substances swallowed by children are relatively harmless, but timely help is very important.
Immediate flow is also necessary if the child loses consciousness, even if only for a short time, after outdoor games in the heat or after a bath or a jacuzzi. Calling a doctor in this situation is not enough. Take the baby to the hospital as soon as possible. External influences are potentially dangerous. They are able to suppress the body's defenses, which in normal conditions do not allow the temperature to rise to a dangerous level. Recognize these states help their preceding events and associated symptoms. I emphasize: loss of consciousness means that the child is in danger.
Fact number 4.
Indications of body temperature depend on the method of its measurement . Rectal (in the rectum) temperature in children is usually one degree higher than the oral one (in the mouth), and the axillary temperature is one degree lower. However, in infants, the difference between the temperature values measured by these methods is not so great, so it is better for them to measure the temperature in the armpit.
I do not advise using a rectal thermometer: with its introduction, perforation of the rectum is possible, and it is fatal in half the cases. Why risk when it is not necessary? Finally, do not think that the temperature of the child’s body can be determined by touch, touching the forehead or chest. This will not succeed either medical professionals or you.
Fact number 5.
Churn body temperature should not be . The only exceptions are newborns suffering from infections, often caused by obstetric interventions in childbirth, intrauterine and hereditary diseases. Acute contagious disease can be the result of some procedures. For example, an abscess under the skin of the head can develop in the infant from the sensors of the device during intrauterine observation, and aspiration pneumonia due to amniotic fluid that has entered the lungs as a result of the introduction of the mother during the delivery of medicines. Infection is possible during the circumcision procedure: there are legions of pathogenic pathogens in hospitals (this is just one of the reasons my grandchildren were born at home). If a baby has a high temperature in the first months of life, it is simply necessary to show it to the doctor.
Fact number 6.
Temperature may rise from excessive wrapping . Children are very sensitive to overheating. Parents, especially first-born children, are often overly concerned about whether or not their children are cold. They wrap babies in a variety of clothes and blankets, forgetting that if he feels hot, he will not be able to get rid of warm clothes on his own. If your baby has a fever, be sure to check if he is too warmly dressed.
If a child with a temperature, especially when accompanied by chills, is wrapped tightly in thick blankets, this will provoke an even greater rise. A simple rule that I recommend to parents of their patients: let the child be so many layers of clothing, how many on themselves.
Fact number 7.
Most cases of fever are associated with viral and bacterial infections , which the body's defenses can cope with without any help. Colds and flu are the most common causes of fever in children of any age. The temperature may rise to 40.5 degrees, but even in this case there is no cause for concern.
The only danger is the risk of dehydration from concomitant processes of sweating, rapid pulse and respiration, coughing, vomiting and diarrhea. It can be avoided by giving the child plenty of drink. It would be nice if the child drank a glass of liquid every hour, preferably nutritious. It can be fruit juice, lemonade, tea and everything that a child does not refuse. In most cases, viral and bacterial infections are easily recognized by the attendant symptoms of fever: mild cough, runny nose, watery eyes, and so on. With these diseases, neither the help of a doctor nor any medications are needed. A doctor cannot “prescribe” anything more effective than the body’s defenses. Medications that alleviate the general condition, only interfere with the action of vitality. I will discuss this in more detail in one of the following chapters.
Antibiotics are not needed either: although they may shorten the duration of a bacterial infection, the risk associated with them is very high.
Fact number 8.
There is no clear connection between the temperature of the child’s body and the severity of the disease . A common misconception about this is not justified. In addition, there is no consensus about what is considered "high temperature", neither among parents, nor even among doctors. The parents of my patients, and I had a lot of them, had diametrically opposite views on this matter. Studies have shown that more than half of the parents surveyed consider the “high” temperature from 37.7 to 38.8 degrees and almost everyone calls the temperature of 39.5 degrees “very high”. In addition, all respondents were convinced that the high temperature indicates the severity of the disease.
It's not like that at all. In the most accurate way, according to the clock, the measured temperature absolutely does not say anything about the severity of the disease, if it is caused by a viral or bacterial infection. As soon as you realize that the cause of the temperature is an infection, stop measuring the temperature hourly. Tracking its improvement in such a disease does not help, moreover, it only strengthens your fears and tires the child.
Some common, non-dangerous diseases, like one-day measles, sometimes cause children to have a very high temperature, while others, more serious, can go on without increasing it. If there are no additional symptoms like vomiting or breathing difficulties, keep calm. Even if the temperature rises to 40.5 degrees.
To determine if the disease is light, like a cold, or serious, like meningitis, the temperature is caused by a disease, it is important to take into account the general condition of the child, his behavior and appearance. All these moments you will appreciate much better than a doctor. You know much better how your child usually looks and how he behaves. If there is unusual lethargy, confusion and other warning signs 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, articles about “temperature-phobia” - about unwarranted parental fear of high temperatures in children, are found in pediatric journals. Doctors have specially come up with this term - a tactic typical of people in my profession “blame the victim”: doctors never make mistakes, and if mistakes occur, patients are to blame for everything. In my opinion, “temperature” is a disease of pediatricians, not parents. And it is the doctors who are to blame for the fact that parents become its victims.
Fact number 9.
The temperature caused by a viral or bacterial infection, if it is not shot down, will not rise above 41 degrees. Pediatricians do a disservice by prescribing antipyretic drugs. As a result of their appointments, the parents' anxiety that the temperature can rise to the extreme, if not to take action, is reinforced and intensified. Doctors do not say that knocking down the temperature does not affect the healing process, nor does the fact that the human body possesses a mechanism (not yet fully explained) that does not allow the temperature to overcome the barrier of 41 degrees.
Only with heat stroke, poisoning and other external influences, this natural mechanism may not work. In such cases, the temperature rises above 41 degrees. Doctors know this, but most of them pretend they don’t. I believe that their behavior is caused by the desire to demonstrate their assistance to the child. In addition, there is a common desire for doctors to intervene in any situation and unwillingness 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 do nothing” ?
Fact number 10.
Measures to reduce the temperature, whether it is the use of antipyretic drugs or wiping with water, are not only unnecessary, but also harmful . If the child is infected, the rise in temperature, which is accompanied by the course of the disease, parents should not perceive as a curse, but as a blessing. The temperature rises as a result of the spontaneous production of pyrogens - substances that cause fever. This is the body’s natural defense against disease. A rise in temperature suggests that the body's healing system is turned on and working.
The process develops as follows: the child’s body reacts to an infectious disease by producing additional white blood cells - leukocytes. They kill bacteria and viruses and cleanse the body of damaged tissues and decay products. The activity of leukocytes increases, they quickly move to the site of infection. This part of the process, the so-called leukotaxis, is stimulated by the production of pyrogens, which increase the body temperature. Increased temperature indicates that the healing process is accelerating. This is not to be afraid, this should rejoice.
But that is not all. Iron, which serves as a food source for many bacteria, leaves the blood and accumulates in the liver. This reduces the rate of reproduction of bacteria and increases the efficiency of interferon produced by the body to combat the disease.
This process has been 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 - increased. Artificial increase in body temperature has long been used in cases where the body of patients has lost its natural ability in diseases.
If the child's temperature has risen as a result of the infection, do not give in to the desire to knock it off with medication or rubbing. Let the temperature do its thing. Well, if your compassion requires you to relieve the patient's condition, give the child paracetamol age-appropriate dosage or wipe the body with warm water. That is quite enough. A doctor is needed only when the temperature lasts more than three days, other symptoms appear, or the child has become very ill.
I emphasize that by lowering the temperature in order to alleviate the condition of the child, you interfere with the natural healing process. The only reason that compels me to talk about ways to reduce the temperature is the knowledge that some parents are not able to resist.
If you do not churn the temperature you can not, rubdown with water is preferable to taking aspirin and paracetamol because of their danger. Despite their popularity, these tools are far from harmless. Aspirin poisons annually, possibly more children than any other poison. This is the same form of salicylic acid, which is used as the basis of 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 drug while they are getting the flu or chickenpox, they may also develop Ray's syndrome, a common cause of infant mortality, mainly due to the effects on the brain and liver. This is partly why many doctors switched from aspirin to paracetamol ( acetaminophen, panadol, calpol, and others ).
Acceptance of this tool is also not the way out. There is evidence that large doses of this drug are toxic to the liver and kidneys. I would like to draw your attention to the fact that children whose mothers took aspirin during childbirth often suffer from cephalohematoma , a condition in which bumps filled with liquid appear on the head.
If you still decide to reduce the temperature of the baby’s body by wiping off, use only warm water. The decrease in body temperature is achieved by evaporation of water from the skin and does not depend on water temperature. That is why too cold water has no advantages. Not suitable for wiping and alcohol: his child’s toxic fumes.
Fact number 11.
High fever caused by a viral or bacterial infection does not cause brain damage and does not cause other negative effects. The fear of heat is largely based on the widespread perception that it can lead to irreversible damage to the brain or other organs. If this were the case, the panic of parents when the temperature rises would be justified. But, as I said, this statement is false.
To those who are familiar with this fear, I advise you to forget about everything that sowed it, and never to take on faith the words about such a high temperature threat, no matter who they may come from - from other parents, elderly people or a doctor’s friend who gives friendly advice for a cup of coffee. And even if such advice was given by an omniscient grandmother. Rights, it is, alas, not always. A cold, flu, and any other infection will not raise a child's body temperature above 41 degrees, and a temperature below this level will not cause long-term harm.
It is not necessary every time to expose oneself to fear of possible damage to the brain of a child with a rise 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 practiced for decades, have seen more than one or two cases with high fever. A temperature rise above 41 degrees is not caused by infection, but by poisoning or overheating. I treated tens of thousands of children and only once observed a temperature above 41 degrees in my patient. No wonder. Studies have shown that in 95 percent of cases of temperature increase in children, it did not rise above 40.5 degrees.
Fact number 12.
High temperature does not cause cramps. They are caused by a sharp rise in temperature. Many parents are afraid of a high temperature in their children, because they have noticed that she has seizures with convulsions. They believe that cramps are caused by "too high" temperature. I understand these parents well: a child in convulsions is an intolerable sight. Those who have 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 fever have convulsions, and there is no evidence that they leave serious consequences.
A study of 1,706 children who had febrile seizures did not detect any motor dysfunction and did not record deaths. There is also no convincing evidence that such seizures 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, wasted: by the time a child has a high temperature, most often the convulsive threshold has already been passed. As I have already said, convulsions depend not on the level of temperature, but on the speed of its rise to a high point. If the temperature has risen sharply, convulsions have already occurred, or the danger has passed, that is, it is almost impossible to prevent them.
To febrile convulsions are usually inclined children under five years. Children who have experienced such convulsions at this age rarely suffer from them. To prevent the recurrence of seizures at high temperature, many doctors prescribe long-term treatment with phenobarbital and other anticonvulsants for children. If these drugs are prescribed to your child, ask the doctor about the risks associated with them, and about what changes in the child’s behavior they lead to.
In general, there is no unanimity among doctors regarding the long-term treatment of febrile seizures. Medications that are commonly used in this case, cause damage to the liver and even, as shown by experiments on animals, have a negative effect on the brain. One of the authorities in this matter once remarked: "Sometimes it is more useful for a patient to live a normal life between episodes of convulsions than to live on medications without convulsions, but in a constant state of drowsiness and confusion ...".
I was taught to prescribe phenobarbital to children with febrile convulsions (to prevent their recurrence), current medical students are taught the same thing. I had doubts about the correctness of prescribing this drug when I noticed that while treating them in some patients, the convulsions recurred. This, of course, made you wonder: did they stop using phenobarbital in other patients? My suspicions increased after complaints from some mothers that the drug over-excites children or slows them down so that, usually active and sociable, they suddenly turn into a half-bomble. Since the cramps are episodic and do not leave long-lasting effects, I stopped prescribing this medicine to my little patients.
If a child who experiences a febrile seizure is prescribed long-term treatment, the parents will have to decide whether to accept it or not. I understand that openly expressing doubts about prescribing a doctor is not easy. I also know that a doctor may dismiss questions or not give intelligible answers. If that happens, it makes no sense to start a dispute. We must take a prescription from the doctor and, before buying medicine, ask for advice from another doctor.
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 the cramps do not threaten the life of your baby and will not bring irreversible harm, and take simple measures to ensure that the child does not suffer during the attack.
First of all, turn the child to the side so that he does not choke with saliva. Then make sure that there are no hard and sharp objects near his head that he can get hurt during an attack. After making sure that the baby’s breathing is not obstructed, 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 comfort, you can call the doctor and tell about what happened.
For the most part, cramps last a few minutes. If they tighten, ask the doctor for help on the phone. If the child does not fall asleep after an attack of seizures, it is impossible to give him food and drink for an hour. Due to intense sleepiness, he may choke.
Quick Guide to Body Temperature
High fever is a common symptom 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 indication of the severity of the disease.
The temperature that rises as a result of the infection does not reach the values at which irreversible damage to the organs of the child is possible.
Elevated temperatures do not require medical intervention beyond what is recommended below. The temperature does not need to churn. It is the body’s natural defense against infection and helps speedy healing.one
If the body temperature in a child up to two months has risen above 37.7 degrees, consult a doctor. This may be a symptom of infection - intrauterine or associated with intervention in the process of childbirth. Increased temperature in children of this age is so unusual that it is more prudent to insure and rather calm down if the alarm turns out to be false.2
For children older than two months, the doctor does not need a doctor when the temperature rises, except when the temperature lasts for more than three days or is accompanied by serious symptoms - vomiting, difficulty breathing, severe coughing for several days, and others that are not characteristic of the common cold. Check with your doctor if the child is unusually lethargic, irritable, absent-minded, or looks seriously ill.3
Call your doctor regardless of the thermometer readings if your child has difficulty breathing, uncontrollable vomiting, if the temperature is accompanied by involuntary muscle twitches or other strange movements or is worried about something else in the behavior and appearance of the child.four
If the rise in temperature is accompanied by chills, do not try to cope with this feeling of the child with a blanket. This will lead to an even higher temperature increase. Chills are not dangerous - this is a normal reaction of the body, the mechanism of adaptation to a higher temperature. It does not mean that the child is cold.five
Try to put the temperate child in bed, but do not overdo it. There is no need to chain the child to the bed and keep it 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, excessive loads and sports are not to be encouraged.6
If there is reason to suspect not an infection as the cause of the high temperature, and other circumstances - overheating or poisoning, take the child to the hospital immediately. If there is no emergency room in your area, use any available medical care.7
According to popular tradition, do not try to starve the fever. Nutrition is important for recovery from any disease. If the child does not counteract, “fatten” both colds and fevers. Both those and others burn reserves of proteins, fats and carbohydrates in the body, and they need to be repaid. If the child refuses to eat, water it with nutrient fluids, such as fruit juice. And do not forget that chicken soup is good for everyone.
High fever and usually associated symptoms lead to a significant loss of fluid and cause dehydration. It can be avoided by giving the child a lot of drinking, the best is fruit juices, but if he does not want them, any liquid will do, preferably one glass every hour.
Via Robert Mendelsohn's book How to raise a child healthy despite doctors ” & wiki.