Home' Australian Journal of Pharmacy : Jan-Feb 2017 Contents related cause for a trip to the
It is also a common fear among
parents and as such, pharmacists
could look for opportunities to discuss
fever and help address and manage
parent s’ worr y.
“Much of parent s’ concerns stem
from potential complications such as
febrile convulsion and brain injury.
What has become termed ‘fever
phobia’ is thought to exist more so in
those who have limited understanding
of fever and its valuable role in
diseases,” says Crellin.
“At the heart of fever management
is parental education along with
ensuring the child is comfortable and
has fluids. Children lose more fluids
when they’re hot so make sure they’re
well hydrated and comfortable.
“None of the other measures that
have been part of the traditional
approach to managing fever, such as
stripping them off, tepid sponging,
putting a fan on—are effective at
“A l l you’re doing is cooling the
skin so that the body works harder
to raise the temperature, which is
“The advice I believe pharmacists
should be giving parents is to keep
the child feeling comfortable. Treat
them in the same way you would if they
didn’t have a temperature. If they feel
quite warm take a layer of clothing off,
this doesn’t mean stripping them. If
they feel cool, add a layer.
“By offering parents these practical
tips pharmacists can help dampen
down some of the fever hysteria.
People are so terribly anxious about
fever but in kids it’s such a common
symptom and in most circumstances
it goes hand in hand with a fairly
“Pharmacists are certainly part
of a team that can promote a better
understanding of what should and
shouldn’t alarm parents when it comes
to the health of their children.
“ Then the next step in the advice
is to advise parents of the things that
they should be concerned about—if
they don’t know what’s causing the
fever, if the child is particularly unwell,
inactive, won’t drink, pale or the parent
has a gut feeling. Don’t focus purely on
the number (the temperature on the
thermometer). The parent’s observation
of their child, based on what they know
about their child’s normal behaviour,
is a much more meaningful piece of
information than a temperature.”
Crellin says, “It’s also important
to relay what constitutes a fever—
anything ≥ 38°C is considered a
fever. For those who are particularly
anxious about a fever, concern over
febrile conv ulsion is probably what’s
underpinning their anxiety.
“It might be helpful for pharmacists
to understand that many parents will
be aware of this possibility and be
alarmed by it and it’s driving their
desire to treat the fever.
“Pharmacists can help alleviate
some of these concerns by advising
that only approximately 2%
of children experience febrile
convulsion as a result of fever and
they’re harmless, albeit scary for
the family, and don’t have lasting
ramifications; they’re not responsible
for brain damage. There’s also no
evidence to suggest that giving
regular Panadol or Nurofen will stop
it from happening.”
Crellin tells the AJP she’d like to see
more health professionals aggressively
encourage treating discomfort
rather than fever. It’s important to
understand what’s causing the fever
and address the underlying cause if
necessary, bearing in mind the vast
majority are viral in nature, which
there’s no treatment for.
“If a large cohort of pharmacists
were promoting a similar message
to paediatric clinicians about fever,
fever management and the use of
antipyretics it would be fabulous.
“ We’re swimming against the tide
with respect to the use of paracetamol
to treat fever as we have a long history
of people saying you should treat fever
because it’s dangerous. We need, clear
and consistent messages.
“One of the big problems we see
in healthcare is the inconsistency in
information and it’s so unhelpful for
parents to be told something by one
clinician and something different
According to an article on fever
management published in the
World Journal of Paediatric Clinicians,
health professionals should see
parental education as a primary part
of fever management.
General health checks can provide
an opportune chance to educate
parents on the best way to treat fever,
as opposed to presenting facts when
the child is sick as anxiety may impede
their understanding. It states that
‘parents should be taught how simply
to assess the child’s wellbeing (e.g.
skin colour, activity levels, respiratory
rate and hydration)’.
medicines can reduce
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