Summer Survival - Health
Ask the Doctor Doctors get countless queries each day from parents about their child’s health. Here are the TOP 3 most common questions, from paediatrician Dr. Christine Chen.
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1
Exactly what temperature is considered a fever?
First of all, a fever is considered to be a rise in our internal body temperature to levels that are considered to be above normal. From your Googling you may get a wide range of answers ranging from 99 degrees Fahrenheit (37.2 degrees Celsius) to 100.4 degrees Fahrenheit (38 degrees Celsius). So you wonder - why is there no straightforward answer? That’s because the definition of a fever includes some reference as to which part of the body the temperature was taken. The following represent the temperatures typically used to define fever: • 99 degrees Fahrenheit (37.2 degrees Celsius) or higher if measured under arm • 99.5 (37.5 degrees Celsius) or higher if measured orally • 100.4 degrees Fahrenheit (38 degrees Celsius) or higher if measured rectally, by ear, or by temporal artery
hat is W the best method
to check my child’s temperature?
2
Opinions will differ about the best site and method of temperature measurement and each has its own pros and cons. Temperature readings may be affected by how the temperature is measured, the device used, how cooperative your child is, as well as environmental factors. When deciding which method to use, parents need to consider whether the accuracy of the results will have clinical implications for their child, for example, any fever in a child younger than 3 months of age may require hospital admission and a thorough investigation into the source of the infection whereas fever in older well looking children may require initial observation. Temperatures measured rectally are
considered to be the most accurate and are used as the reference standard for measurement of core body temperature. Rectal readings can be affected by the depth of measurement of the thermometer tip and the presence of stool but are least likely to be affected by external factors such as over bundling and recent ingestion of hot or cold beverages. Many parents are uncomfortable with this method of temperature assessment and older children are more likely to resent it. However in young children especially in newborns in whom a low grade fever may signify a serious illness a rectal temp should be checked. Ear thermometers are quick but are not reliable in young children as they have smaller ear canals especially before 6 months of age. When used in older children it needs to be placed correctly in your child’s ear canal to be accurate. It is very important to straighten the ear canal and insert the probe tip comfortably and completely in the ear canal to ensure accuracy. For children 6 to 12 months pull the ear straight back. For children over 12 months pull the ear up and back. Too much earwax can cause the reading to be incorrect. Temporal artery thermometers are quick and non invasive and hence attractive to use but are the most expensive option. Readings are close to core body temperature but its accuracy is affected by sweating, blood flow, and the environmental temperature and there are conflicting reports on its accuracy to date. Oral temperatures rely on the child being old enough to cooperate with holding the thermometer under the tongue with the lips closed around it, long enough to get an accurate reading. This is often a challenge for most children younger than 4 to 5 years old and those who are very stuffy and need their mouth to breathe. Its accuracy will also be affected by the recent ingestion of hot or cold beverages or food. As rectal temps are less likely to be tolerated by older children, oral temperatures are preferred. Axillary temperatures are the least accurate in measuring core body temperature and are most impacted by environmental factors such as swaddling,