Temperatures. We all have them, we all deal with them, kids especially. Until the age of 5 children cannot control their core temperature as well as adults so are prone to high temperatures when fighting any major or minor infections. To that end, we give Calpol and do so because it contains Paracetamol. Paracetamol is an 'anti-pyretic' and will bring the temperature down. If the temperature isn't controlled there is a risk of a febrile convulsion which can be scary to see for a new parent. Generally, it is common sense though. Before I started this job and had any medical training I was a parent. I didn't have a clue what I was doing but I knew when my son was ill and knew that when he had a temperature I was to keep him cool and give Calpol &/or Nurofen. Apparently, I was one of the lucky ones though! Lucky because I was given this closely guarded secret and extremely useful knowledge.
"2 year old male, fever"
Wednesday lunch time. We had done the usual mix of slips, trips, falls and chest pains when this job came down. My first thought was 'So?!' That was the only information we had to go on which was reflected in its low priority category. We arrived at the tower block and rung on the bell. The piercing buzz of the locking mechanism echoed down the corridor towards the 'not so welcoming' looking lift. We risked it anyway as 16 floors was not about to be walked! The smell of urine and graffiti on the wall told us all we needed to know really. We arrived at the flat, the door was open, so we wondered in. Sitting in the living room were both parents and the child. Our patient was lying on the sofa, dummy in mouth, looking around inquisitively whilst wrapped in about 20 layers of clothes and various blankets!
"What's the problem today?"
"He's gotta tempricher"
"OK, how long for?"
"I reckon bout an hour ago or summit"
"And have you given any Calpol?"
"Nah"
"Have you got any?"
"Nah"
I got out our Calpol whilst shaking my head a tad. He did have a temperature but not that high. I removed most of the clothing whilst reminding them that dressing a hot baby as an eskimo will not lower the temperature!
"Has he been unwell at all? Any cough or cold symptoms?"
"Nah"
"Any vomiting or diarrhoea or pain you are aware of?"
"Nah"
"So what made you worried enough to call an ambulance?"
"He's gotta tempricher"
SO WHAT?! She didn't get where I was trying to go with this conversation. I tried my best to explain that kids get temperatures and that doesn't mean they necessarily need an ambulance. The kid was happy as anything! Perhaps if the temperature lasted a number of days and he wasn't well and didn't respond to treatment, then perhaps a GP would be a good idea, but a 1 hour history?! Hmmmm. Sadly my words of wisdom were lost on her! Hospital it was!
2 hours later.........
"4 year old female, fever and shaking"
It was clearly going to be one of those days. We'd spend half the shift picking people up off the floor and now the latter was being spent taking temperatures and administering Calpol! In stark contract to the first job we were now driving towards a very affluent road. We pulled up outside this grand detached house with a huge double garage as separate outhouse. Parked outside the garage was a Porsche 4 x 4 and a branch new Range Rover. I couldn't help a sarcastic 'Oh...so they do have cars' comment as I ventured up the path to the huge front door. As I learnt towards the doorbell, the door opened. A very well spoken woman in her 30's opened the door. As we walked towards one of the living roomS I couldn't help but think that given a house like this I'd do a better job! Sitting in a high chair was the kid. He had a flushed face and looked tired and grumpy. I'm not surprised. He had a whopping temperature! 40.9 to be precise! I'd be grumpy if I was that hot!
"What's the history? What's been going on?"
"Well, it started about 3 or 4 days ago. He's generally been under the weather and not himself but I thought it would pass but it hasn't"
"So what has changed today?"
"He had a convulsion about an hour ago and has since been really groggy, I'm getting a bit worried now"
"And have you spoken to his GP at all?"
"Oh no, I didn't think of that!" she said with a jovial tone. Haha.....
"What time did he last have Calpol?"
"He hasn't, we don't do Calpol, we don't agree with it"
"Well it's what is going to bring his temperature down. That's what the hospital will most likely want to give"
"Well as parents we decided not to use unnecessary drugs"
I skipped on. I was never going to win. I wasn't educated. She was. I have no money. She was rich. She was talking down to me. I wanted to be done with this job. We took her and her kid to hospital & I left the department grinning, as the nurse schooled her on the benefits of temperature control, whilst sad next to our previous patient! I wear smug very well indeed!
Seriously though, when did the concept of giving kids Calpol get forgotten. These are by no means isolated jobs. Most kids we see with temperatures have not had Calpol. That is probably partly because the ones who have had Calpol don't need an ambulance. See, there is a clue! Temperatures need treating, they don't need ambulances. Kids with temperates also still fit into their own car seats......just a thought! A temperature on its own is also not a medical emergency. It is simply the bodies way of fighting off an infection. Let it do it's thing! Also, please please please don't wrap them up in every piece of fabric you can find. I really did think that people knew this when I started the job. It's just common sense. As for wanting to go to hospital, 4-6 hours sat on a metal chair in a waiting room will probably make things worse for all involved. Giving your child Calpol when they are unwell is basic parenting and personally, refusing to give it 'on principle' is negligent. If the kid grows up and decides he or she doesn't want to take it then fine, but to risk a child's health and comfort because of a warped principle is wrong.
I'm not saying don't call an ambulance, I'm simply saying do the basic things to reduce a temperature first. If they are unwell and showing signs of serious illness, have a rash or go floppy the do not hesitate but a one hour history of a moderate temperature is not an emergency. That is all!
For tips on treating a fever see the NHS Choices website.