Management of uncomplicated fever in children Free Essay Example, 2000 words

At what minimum doses this can occur is not yet known. Some studies have shown that a dose of 150mg /kg/day can cause hepatic toxicity (JBI 2001). The normal dose given in children in current practice is 90 mg/kg/day. Of late, it is recommended to give 60mg/kg/day (JBI 2001). Considering the fact that paracetamol can get accumulated in the body, even 90mg/kg/day can lead to 150 mg/kg/day after 3-4 days of treatment (JBI 2001). Hence cautious use of paracetamol is warranted. This drug has more pronounced effect in children less than 2 years, or who are sick and receiving doses every 4th hourly (JBI 2001). Shann (1995) has reported that it is helpful to give paracetamol in those who are febrile and have cardiac or respiratory failure because paracetamol reduces oxygen consumption, carbon dioxide production and cardiac output. But, in those with normal heart or lung disease it is not necessary to give paracetamol because fever is harmful only at temperatures over 41 deg C and in practi ce such high temperatures are usually caused by heat stroke or brain injury. The question here as per the scenario is whether fever in children should be treated with paracetamol every four hours or less frequently. We will write a custom essay sample on Management of uncomplicated fever in children or any topic specifically for you Only $17.96 $11.86/pageorder now I have retrieved 2 sources on this topic to form a policy. 1. Meremikwu, M., & Oyo-Ita, A. 2002. Paracetamol for treating fever in children (Cochrane Review). The Cochrane Library, Issue 4, Oxford Update Software. 2. Huang, S.Y. , & Bavid, S.G. , 2004. Effect of Recent Antipyretic Use on Measured Fever in the Pediatric Emergency Department. Arch Pediatr Adolesc Med. , 158, pp. 972-976. The first article by Meremikwu and Oyo-Ita (2002) is a systematic review to evaluate the benefits and harms of various methods of managing fever in children from randomised controlled trials. This study can be categorized in the Level 1 of the JB hierarchy. By knowing this hierarchy level, one can assess the validity of recommendations for clinical guidelines, focuses and the effectiveness of treatment. According to this article, there are controversies regarding the effectiveness and safety of various methods for treating fever. Of all the antipyretics (paracetamol, ibuprofen, aspirin, nimisulide), paracetamol has the least side effects. But it is not that this drug is absolutely safe. It has the potential to cause liver toxicity. Another question raised in this review is whether it is necessary to bring down fever at all. The review stated that fever might actually have some beneficial effects of enhancing host resistance to infection and that bringing down the fever could increa se mortality in severe infections, prolong viral shedding and impair antibody response to viral infection.