THE USE OF ANTI PYRETICS TO TREAT FEVER IN CHILDREN

Does the Use of Antipyretic to Treat Fever in Children Prolong the Length of the Illness?

Table of Contents

Chapter 1: Introduction And Background3

Background of the study3

Problem Statement7

Purpose of the study8

Rationale of the study8

Significance of the study11

Research Question13

Chapter 2: Literature Review14

Chapter 3: Methodology61

Research Design61

Search strategy61

Study selection64

Keywords Selection64

Critical framework64

Critical framework selected- NICE Guidelines66

Chapter 4: Discussion/Conclusions68

Chapter 5: Reflection74

Chapter 6: Implications for practice/management/further research77

References82

Chapter 1: Introduction And Background

Background of the study

A raised temperature is a symptom seen frequently by practitioners working with infants, children and young people. (Broom, 2007) Fever is a common event and is often an indication of a self-limiting viral infection, rather than a bacterial or serious illness. However, each year 100 infants aged 1-12 months die from infection and it is likely this number could be reduced by improved recognition, evaluation and treatment of febrile (feverrelated) illness (NICE, 2007). The cause of fever can be difficult to identify and it can be an indicator of a major illness such as meningitis, septicaemia, urinary tract infection or pneumonia. Several recent studies reported that health professionals often perceive fever to be harmful and that nurses can be confused about the risks and benefits associated with fever. Nurses and parents are often fearful that a fever will lead to febrile convulsions. Fever phobia' can result in interventions that do not reflect current knowledge and as a result, may be inconsistent, inappropriate and ineffective.

Most fevers are self-limiting and many children readily tolerate temperatures of 39°C. Uncomplicated fever is relatively harmless and is an important immunological defence mechanism (JBIEBNM, 2001). When associated with infection, fever seldom exceeds 40°C and poses a negligible risk of brain injury (Casey, 2000). The regulation of body temperature involves a complex series of physiological responses (Broom, 2007). In the brain, the hypothalamus regulates temperature like an internal thermostat. The level or 'set-point' of this thermostat can be reset by substances known as pyrogens, resulting in the development of fever. When the set point in the hypothalamus is reset to a higher position, the blood flowing through the hypothalamus is perceived as being below the correct temperature, triggering mechanisms to conserve and generate heat (Casey, 2000). Factors other than the underlying cause of fever can also influence body temperature. Heat and humidity in the surrounding environment can reduce the amount of heat lost through the skin and a reduction in circulating blood volume, as the result of haemorrhage or dehydration, can cause the temperature to increase (Casey, 2000). It is an essential part of nursing care that you understand the process of temperature control and take appropriate steps to identify if a child's fever may be a sign of severe illness. It will help you provide optimum care to review your knowledge and understand the patho-physiology of fever. (JBIEBNM, 2001) The NICE guidance (2007) describes a 'traffic light' system for assessing the child with a fever. Using it can help you ensure that a child receives prompt and appropriate management for his/her ...