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Child fever overwhelms emergency departments

Friday June 25th 2021

Three Royal Colleges have today issued advice for parents concerned about fever in their child after UK hospital emergency departments report being overwhelmed with cases.

The Royal College of Paediatrics and Child Health (RCPCH), the Royal College of Emergency Medicine (RCEM) and the Royal College of GPs (RCGPs), say the guidance follows a rise in infections usually seen in winter.

EDs are seeing children with fever that is related to a rise in respiratory infections, the colleges report. These are usually infections seen in the winter months, but the easing of lockdown has meant children are being exposed to them in the summer as they mix with other youngsters.

Dr Dan Magnus, consultant in paediatric emergency medicine at the Bristol Royal Hospital, said his hospital is having to run a winter-led ED response in the summer, having set a new record for the number of children seen in 24 hours.

Dr Richard Burridge, consultant paediatrician and lead for the children’s emergency department at Watford General, said it had seen three times the number of children with fevers for early June than in 2020.

Dr Camilla Kingdon, president of the RCPCH, said: “Many emergency departments are currently overwhelmed and there has been a particularly steep rise in the number of young children presenting. Some have seen the highest ever numbers of children in their department and waiting times can be huge.

“The biggest increase we’re seeing is in children with mild fever. Fevers are very common in young children and usually aren’t serious. But many parents haven’t seen fever in their child before and are worried, particularly if they don’t have their usual sources of support to turn to, such as parent groups.”

Dr Michelle Jacobs, from the RCEM Paediatric Emergency Medicine Professional Advisory Group, said: “We absolutely understand and recognise that parents may be concerned, especially if their child is young and this is the first time that they have been unwell. But if they take their child to the emergency department there may be a long delay, potentially over four hours, before being seen which may be difficult and distressing for both parents and children.”

Professor Martin Marshall, Chair of the Royal College of GPs, said there should be no hesitation in taking a young child to A&E if there is a medical emergency, but in most cases of mild fever, runny nose or cough, paracetamol or ibuprofen can help. Parents should also seek advice from a pharmacist, their GP or by calling 111.

"We understand that it's a really difficult time to be a parent of a young child, particularly if the child has been born during the pandemic, as many of the usual support services parents rely on have not been available, and we hope they find this guidance helpful when making decisions about their child’s health,” he added.

The advice says for most children, treatment with children’s paracetamol or ibuprofen is usually enough to reduce the fever after a few days and they should stay hydrated by drinking clear fluids, such as water or squash.

Concerned parents should call their GP practice or, outside of normal hours, call 111 or the GP out of hours service. Pharmacies can also offer medical advice.

The guidance adds that medical advice should be sought – or go to A&E – if: a baby under three months has a temperature of 38°C (101°F) or higher; a baby is three-six months old and has a temperature of 39°C (102°F) or higher; if the child is dehydrated – for a baby this means taking less than half of their normal feeds and having less than two wet nappies a day.

It is also appropriate to go to A&E if a child develops a red rash that does not fade when a glass is rolled over it; if a child has a convulsion; if a child is crying constantly and cannot be consoled or if the cry sounds different from their usual cry; or if they have a fever that lasts for more than five days or if they become more unwell.

Tags: A&E | Child Health | Flu & Viruses | NHS | UK News

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