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Child’s Fever: When You Should Go to ER

April 21, 2021

When your child isn’t feeling well and has a fever, it’s easy to fixate on the thermometer’s reading. How high is too high? Is it better to take them to the emergency room or to treat the fever at home?

A normal body temperature is 98.6 F. A temperature of 100.4 F and above is defined as a fever. In general, a temperature of 101 F or lower is a low-grade fever, and a high fever is 102 F or higher. A high fever isn’t indicative of how sick your child is, however. There are some signs to look for to help you decide if it’s time to take your child to the hospital.

What Childhood Illnesses Cause Fever?

A fever itself generally does not cause harm and is a sign the body is fighting an infection. Conditions that can cause fever in children:

  • Common cold

  • Ear infection

  • Flu

  • Kidney or urinary tract infections (UTIs)

  • Stomach bug (particularly in small children)

  • Strep throat

  • Viral rashes, such as roseola

A high fever doesn’t always mean there’s a serious problem. It’s important thing to look for other symptoms that accompany the fever to determine if medical attention is required.

Letting Fever “Run Its Course”

The latest recommendations are to allow the fever to “run its course” if your child is active and playful as well as drinking and eating normally. If your child is uncomfortable, you may want to treat the fever with acetaminophen (Tylenol) or ibuprofen (Motrin). Acetaminophen is FDA approved for children 2 months of age and older, and ibuprofen is approved for children 6 months of age and older.

When To Head to ER

Fever alone usually is not reason enough to head to the ER, but there are other things to look for when deciding to seek medical attention. Seek emergency care if your child shows any of these signs:

  • Blue lips, tongue or nails

  • Constant crying

  • Refuses fluids or is too sick to drink adequately

  • Experiences a febrile seizure (seizure brought on by high body temperature)

  • Has signs of dehydration (urinating less frequently, no tears when crying)

  • Limpness/inability to move

  • Moderate to severe stomach pain

  • Sluggishness or trouble waking

  • Stiff neck

  • Trouble breathing or fast breathing

  • Rash or purple spots that look like bruises

If your child has a fever but none of these emergency signs, consider treating at home, seeing your child’s primary healthcare provider or going to a walk-in clinic. Your child may have a viral or bacterial infection that requires treatment but doesn’t need an ER visit.

Your child’s behavior is more important than the number on the thermometer. Most fevers can be cared for at home. With plenty of fluids and rest, they should be feeling better within a few days.

How To Take an Accurate Temperature

The most accurate way to take a child’s temperature is by using a rectal thermometer. But many parents are unsure how to use these so instead use the type of thermometer that swipes across the forehead, also called a “temporal artery thermometer.” These thermometers read heat waves coming from a blood vessel that runs across the forehead just below the skin.

Place the thermometer sensor at the center of your child’s forehead. Slowly slide it across the forehead toward the top of your child’s ear, keeping the thermometer in contact with the skin. Stop when you reach the hairline, then read your child’s temperature on the display screen. Some newer models of forehead thermometers do not require you to slide them across the forehead for an accurate reading.


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