At what point do you go to the ER?

[Jodi AKA BostonTeacher]

Hi everyone,
My son woke up from his afternoon nap screaming and felt so hot. We took his temp and it was almost 103. We gave him tylenol and called the ped. who said basically to give him tylenol and it should bring the fever down.

It did.

Overall his spirits were great and it seems like he is teething. He's had his hand in his mouth, is drooling like crazy and gets really cranky when he eats (though his appetite is good). The tylenol (and cool bath) seemed to lower his temp to 100.8. We took him for a ride in the car since I had to run an errand and he napped for a half hour or so. We just got home and he is really hot again. He was scheduled for another dose of tylenol at 9:00 and at that time his temp was up to 104.1.

At what point do you think we need to go to the ER. I dread the idea of going if this is nothing to worry about, but at the same time I don't want to not go. We've been very fortunate in that he's been super healthy all year so we don't really have experience with this.

His birthday is tomorrow and we are having 25 people over for a party. I'm so torn on what to do and would appreciate advice. TIA

[BTB]

Fever by itself isn't that big of a problem unless it's so high febrile seizures become a worry, or if it won't budge with antipyretics and comfort measures. The real question is what is causing the fever - a benign problem, or a potentially serious one? If DC's eating, arousable and consolable I wouldn't go to the ER. Calling your son's personal physician (even paging them tonight) is more efficient, more personalized, and cheaper, and avoids potential exposure to the ED's germ flora.

[NicoleWisconsin]

Remember to trust your instincts as a mother, too. When DS was 4 mos old, he had a fever and some other symptoms and I called the nurse line and they said that THEY were comfortable with us staying home... *I* just didn't feel right and I knew something was wrong. We took him in and it turns out that he had (the beginning stages of) pneumonia. Had we not taken him, it could have gotten very serious.

The other night, he had a fever up to 103.3... I called the Dr. and talked to him and felt comfortable keeping him home. Everything was fine - probably was hands foot and mouth, but that's another story.

*hugs* Hope he's better soon!

[vjel]

I agree w/ BTB (well, the part where I actually understood what she was saying ;) ). If he is behaving fairly normally and his fever goes down w/ tylenol or motrin and a bath helps, then I would prob just keep monitoring him. If nothing is working, I'd be more inclined to call the dr first and see what s/he says. You know your son best, so use your best judgement. Just make sure he stays well hydrated.

This happened w/ my dd last year. We ended up taking her to the ER (after calling the after hours advice line). it was a TERRIBLE experience. The hours of waiting (b/c it wasn't a true emergency to them), the xrays, the catheter, IV, etc. was just too much for me. She was so tired as it was and to be poked and prodded made her hysterical and made her even more exhausted. After 6hrs in the ER, they figured the fever was a reaction to a vaccination she had gotten days earlier.

As a first time mom, it's hard to know what to do...and you think it's just better to err on the side of caution. I panicked b/c of the high fever. Had the dr. actually called me back (like i was told she would) instead of just telling the advice line person to tell me to take dd to the ER, we might've realized that she was having a reaction to a shot and avoided the whole ordeal. :rolleyes:

[curlywig]

Ditto what the PP said about BTB...

Something you might want to ask your ped about too: When my DS had a high fever 104 and Tylenol wasn't bringing it down, our ped said to alternate doses of Tylenol and Motrin. So we gave Tylenol, then Motrin about 2 hours later. We could then give the Tylenol 4-6 hours after his first dose, and Motrin at 6 hours after the first Motrin dose. Make sense? Our ped told me to "alternate" them, and before I asked for clarificatin, to me that meant Tylenol, then Motrin 6 hours later, Tylenol 6 hours after that, etc.

The combination really helped lower DS's fever along with tepid baths.

When DS's fever was that high, I too asked the advice nurse, "At what point to I have to do something else?" Just seeing 104 on the thermometer was frightening to me. She said that as long as he wasn't inconsolable, eating/drinking fluids okay and demeanor wasn't horribly off, we were probably okay.

Trust your instincts though, and definitely speak with your doc when you're concerned.

[BooeyJ2]

We never went to the ER for fevers (since they can be very sporadic and can usually be brought down pretty easily - a.k.a - by the time we would have gotten to the ER, the fever probably would have gone down and we would have looked like "the neurotic parents").

If the Tylenol isn't working, a good and easy way to bring a fever down is to give your DS a lukewarm (more on the cool side, but not freezing) bath and let him AIR dry. I believe the skin will absorb the moisture and help to bring the fever down (I read about it in a book or online and it always worked for DD).

If the fever is accompanied by vomiting, diarrhea, lethargic-ness, etc, and doesn't go away, then I would bring him to the ER. I would hate to drive to the ER, wait in the waiting room (for anywhere up to 1 hour+) just to be told "just give him Tylenol", etc...and trust me, ER docs are very to the point...plus the trip won't be cheap...even with insurance.

Try the cool bath and air dry though. It should bring his fever down and help him feel a bit better.

Good luck :)

[NicoleWisconsin]

How is he doing today? Are you having the party?

[jbemommy]

I want to try to clarify the alternating tylenol and motrin thing: it's very important to space them correctly to avoid overdosing them. The length of time between motrin doses is 6 hours, and the length of time between tylenol doses is 4 hours. So if you give a dose of tylenol, and then 3 hours later a dose of motrin, then 3 hours later a dose of tylenol, then 3 hours later a dose of motrin, you will be fine. Just don't give them closer than that or you'll be overdosing the motrin. And remember that this actually hasn't been studied to prove it even makes a difference. As BTB said, the fever itself is not dangerous, so try not to get too freaked out about that. Look at how your child is acting and other symptoms they are having.

[dbers]

When dd had a high fever - I asked about febrile seizures - we were told by two different doctors that it wasn't how high the fever was, but how fast it went up. They also said that if a seizure is going to happen, there's not much you can do to stop it...and that fevers, in and of themselves, are actually good because it means the body is fighting something. Hope he's feeling better!

[cjones15]

Both of my girls always run very high fevers - 105. It is just normal for them. Fevers are actually a good thing because they are fighting off the infection. I've never taken them to the ER just for a fever. I had DD#2 in the docs office with pnuemonia and a 105.1 fever and the doc still sent us home with no mention of the ER. A luke warm bath is one of the best things and make sure you just have them in a t-shirt and diaper. If you try to sweat out a fever (like the old days) and giving tylenol they fight against each other and the fever will go up or not break. Keeping them hydrated is also very important. The big problem with ER's is you can wait forever - I've had to wait 6 hours once in the waiting room when DD was dehydrated and our doc sent us over. You never know what other problems everyone else has and can end up leaving worse then when you went in.