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Tuesday, January 25, 2011

What To Do If Your Child Has a Fever

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There is some medical disagreement concerning the medical need for Temperature control. Some doctors recommend paracetamol to lower temperature others do not. Usually children and adults feel better and function better it their temperature is reduced to near normal

Remember paracetamol is very dangerous in overdoseIf your child's temperature is above 37.50C, give Paracetamol ("Panadol" is a common brand) in a dose according to your child's age - follow the dose instructions on the label and repeat the dose every four hours if necessary.
Do NOT give more frequently.

Place body temperature is 370C. If you take the temperature by placing the thermometer under the arm then add IC to obtain the Internal Temperature.  For example: If the underarm Temperature is 36.80C then add 10C to obtain the internal temperature of 37.80C which is the temperature you act on. If your child's temperature is above 38.50C, give Paracetamol and then a tepid sponge bath: Fill the bath with tepid water (not cold water).

Place the child in the bath and wet the child's head with a face cloth. Continue to run the water over the head and body until your child's temperature comes down to 37.50C or less. This may take 20 minutes or more. Do not leave the child unattended in the bath. Take the child's temperature every 10 minutes while in the bath. If the child is shivering then remove the child from the bath immediately.

Shivering increases internal body temperature. Pat the child dry - rubbing dry also increases body heat. Alternatively, you can just let the water evaporate without drying your child.

If your child has a fit because of the high fever, immediately lie the child on its side - this will protect the airway and the child will not swallow its tongue. Do not place objects such as spoons or fingers in the child's mouth. It is very frightening to see a fit but try to stay calm and keep reassuring yourself it is unlikely your child will have any lasting effects from that fit. It is unlikely epilepsy will follow. However subsequent fits with high fevers are more likely.

If the child's fit lasts longer than 5 minutes, call a doctor or take the child to the Hospital Accident & Emergency or call an ambulance.

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How to Tell if Your Baby is Really Sick

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Use the ABCT Fluids In, Fluids out system:
A is for Arousal, Alertness & Activity.
A baby is at much higher risk if it is more drowsy than usual, cannot wake properly, does not respond to normal stimulation and is less active. The more drowsy, the more serious is the illness. If there are periods of normal activity and alertness, serious illness is less likely.
B is for Breathing difficulty.
This is characterised by a heaving chest with indrawing of ribs and sternum or grunting with breathing.
C is for Circulation.
Poor circulation is shown by being suddenly and persistently pale all over or having cold legs up to the knees.
T is for Temperature.
If your baby has a Temperature 38oC or & 36.4oC then seek medical advice.
Fluids In:
Feeding less than half normal over 24 hours.
If a baby is breast fed then consider the frequency of feeding and the duration of active sucking over 24 hours. If bottle feed, count up the volume of milk taken over 24 hours and compare it with the baby’s normal intake.

Fluids Out:
Fewer than 4 wet nappies per 24 hours.
In babies under 6 months of age this is an indication of increasing risk of dehydration.
- The more of these symptoms present, the higher the risk of serious illness.
- Review is essential with babies: If any doubt with babies seek medical advice.

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How To Get To Sleep

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Many people experience sleep difficulties during their "settling in" period in Jakarta or any other post.
1. Go to bed only when you are tired. Do not eat, drink, read, smoke or watch TV in bed. Get up if you are not sleepy.
2. Get up at the same time every morning. Set your alarm clock.
3. Avoid spicy food, caffeine, or too much liquid with your evening meal. Coffee, tea, chocolate and cola drinks contain caffeine.
4. Keep nights free from stress. Don't think in bed. Deal with problems when they happen during the day. Don't let them build up and dominate your sleep time.
5. Do not drink alcohol before bed. A night cap will induce lighter sleep and sleep will be less refreshing.
6. Exercise after work and before dinner. Morning exercise does not induce sleep and late evening exercise makes sleep more difficult.
7. Control noise. Older people are more easily disturbed by noise.
8. Have a hot shower or bath immediately before going to bed.
·          Alcohol and sedatives are only a temporary solution. Their long term use will disrupt your sleep.
·          Not everyone needs 8 hours sleep.
If you are having a real problem with early morning ()  wakening  and can’t get back to sleep then contact the hospital

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