Fever
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Question Received:
Response:
I understand that there are a few ways to reduce fever : by sponging, taking medication, giving cold compress and wearing lighter clothing ... are there any other ways besides these?
16th May 1999
The methods you have suggested are all relevant. Here are some additional nursing measures that could be used:
Environmental temperature - if possible, keep this lower than the peripheral body temperature
Electric fan - the constant movement of air over the surface of the body will enable sweat to evaporate and aid surface cooling. Using a fan when performing tepid sponging will also achieve similar results
Administer cool or cold drinks - this has a slight cooling effect and whilst not significantly lowering the body temperature it can help the person to feel more comfortable. Also offering crushed ice to suck might help
Use clothing and bedding of pure cotton - cloth made from this natural fibre is light and allows air to circulate over the skin surface and facilitate heat loss
A cool shower can help - if the person’s condition allows. Sitting in a bath whilst a nurse or care assistant sprinkles cool water over the person's body should enable both physical and psychological comfort to be achieved. It will of course be essential to check that the water is at an appropriate temperature before allowing it to come into contact with the person's skin
Hair care - it is always good nursing practice when caring for a person who is feverish to help them maintain their hair. A person with a fever is generally weak and listless and might feel worse if their hair is not kept clean and tidy. Psychologically people feel differently if they are helped towards maintaining their 'normal' appearance.
Drug treatment - aspirin, antipyrine, aminopyrine and other substances have antipyretic actions and may be administered. However, the unwanted effects of aspirin have to be taken into account: gastric irritation, tinnitus and hypersensitivity reactions. Aspirin should not be given to a child under 12 years because of the risk of Reye's syndrome (Aronson and Grahame-Smith, 1992).
Fever is often associated with bacterial infections. Lipopolysaccharides released by some bacteria and known as pyrogens cause the heat-regulating centre in the hypothalamus to reset the body temperature to a higher level. However, some alternative causes are possible: fever can be produced by abnormalities such as a tumour in the brain, by tissue damage, by toxic substances, and by dehydration. It is worth remembering that moderate fever induced by infection may be beneficial in the sense that it accelerates chemical processes in the immune system and speeds the destruction of causative organisms.
The tissues of the body are able to protect themselves during a transient moderate increase in temperature by producing a greater abundance of special molecules known as heat shock proteins. The heat shock proteins protect other essential proteins from heat damage. The danger is that when body temperature rises above 41° C (106° F) this protective mechanism is no longer effective and permanent damage can occur in some tissues, particularly the brain. It is for these more extreme fevers that the interventions outlined above are necessary.
Reference
Aronson, J.K., and Grahame-Smith, D.G. (1992) Oxford textbook of clinincal pharmacology and drug therapy (2nd edition). Oxford: Oxford University Press (salicylates p 677).
For a general account of the regulation of body temperature and fever, see:
Guyton, A.C. (1992) Human physiology and mechanisms of disease (5th edition). London:W.B. Saunders Company (pp 534-541).