Taking Care of Fever and Pain in the Middle of the Night

When the sun goes down, people worry more.  They stay awake at night worrying about their job, their relationships, their finances.  There are few other people awake with whom to talk the worries out.  And when kids get sick with fever or pain at night, the worriers bring their kids to the Emergency Department.  When I ask "Did you give any medicine?" for the ear pain or fever, often they say no, or they did give some but not nearly enough.  And why didn't you give more?  "I was afraid to." Fear is the enemy of the parent and the pediatrician at night, and knowledge is the weapon we give to parents to fight that fear.  The first knowledge point, that I repeat again and again in this blog and at work: fever will not hurt your child.  Fever does not cook brains.  Fever and seizure are very rare, and the seizures do not hurt your child either.  Fever is not the enemy, fear of fever is.  The second point then is this: give a medicine for the pain and the fever, and give enough.  Most of the time enough medicine will help reduce the fever, take away the pain ,and get you easily through the night where you can see your doctor the next day.  Medicine is not the enemy, fear of the medicine is. Our two pain and fever medicines are acetaminophen (Tylenol) and ibuprofen (Motrin, Advil).  If you give as much as it says to on the bottle (not less!), and give it at the recommended times, you will be perfectly safe.  If you are not sure of your measurements, call your doctor or the pharmacy.  Your doctor should have someone to talk to at night, and there are 24 hour pharmacies in the area as well.  It is much better to call first and give enough of the right medicine than to come into the Emergency Department and wait for hours for something you could have taken care of at home.  When you measure medicines, you need to be sure you are measuring with the right spoon.  "Infant's" pain and fever medicines come with their own measuring droppers- use only the dropper that came with the bottle- don't use any other thing to measure those with.  For "Children's" medicines that call for teaspoons, use a measuring teaspoon like you would use for cooking.  Don't use your regular teaspoons-those are often smaller than the measuring spoons and you won't give enough medicine.  If you are not sure of your spoons, get a measuring syringe from your pharmacy or doctor, and ask about which are the right marks to measure with.  Fear is the enemy.  Don't be afraid of fever and pain.  Don't be afraid of the medicines, they are designed to be very safe.  And don't be afraid to call for medicine advice.  We are much happier to answer phone questions about medicine at night than we are about seeing kids who could have been taken care of at home.