Doctors show how to safely reduce fever for children with dengue fever

Dr. Dr. Nguyen Minh Tuan, Head of Dengue Fever, Children’s Hospital 1, Ho Chi Minh City, said that children under 6 years old if their high fever does not go down continuously, they are very susceptible to convulsions. Therefore, reducing fever is the first concern of parents when their child has dengue fever or other infections.

With dengue fever, a safe medicine to reduce fever in children is paracetamol. The drug may be in the form of tablets, sachets, syrups or suppositories, but the dose should be based on weight. The usual dose is 10-15mg/kg body weight/time, repeat every 4-6 hours.

Doctor Minh Tuan noted, the drug should only be used when the child has a fever of 39 degrees Celsius or higher, not regularly or too early, too much. The reason is because the dengue virus (which causes hemorrhagic fever) can affect liver function, the disease can easily be complicated by liver failure. If you use “easy” paracetamol, the baby’s liver will be even more vulnerable.

However, if the child has a history of allergy to paracetamol, is another drug effective in reducing the fever? Some drugs such as aspirin, ibuprofen also have the effect of reducing fever and pain, but doctors warn, absolutely do not use for children with dengue fever.

Doctor Nguyen Minh Tuan explained, children with dengue fever are prone to gastrointestinal bleeding, bleeding gums, nosebleeds, vaginal bleeding… due to increased vascular permeability, thrombocytopenia, and blood clotting disorders.

Aspirin, ibuprofen, in addition to antipyretic effects, also inhibit platelet function, reduce platelet concentration, and make platelets no longer able to stop bleeding. Dengue fever patients taking these two drugs will be at risk of gastrointestinal bleeding due to peptic ulcers.

The safest option at this time is to cool the child. Parents use a small cotton towel dipped in moderately warm water, wring it dry and apply it on areas where large blood vessels pass through such as the sides of the child’s neck, armpits, and groin. Wipe the forehead, chest and loose clothes and give the child plenty of water to drink.

Normally, about 1 hour after wiping, the baby’s temperature will drop from 39 degrees Celsius to less than 38.5 degrees Celsius. Cooling can be repeated many times after that.

“This is a very effective and safe measure,” said Doctor Tuan. However, he also expressed concern when there were still misconceptions such as shaving the wind, cutting the body to relieve colds, reduce fever, and cure aches and pains in folklore.

The skin scraping site will be scratched, red, bruised or oozing blood. Bleeding cuts may not be stopped because the disease is characterized by bleeding. From here, germs enter the outside to cause blood infection, the development of septic shock. The child will be in critical condition because the condition is very serious.

“Absolutely don’t shave or cut off when children have dengue fever,” the doctor said.

To take care of a child with dengue at home, the doctor advises that the child needs to rehydrate with plenty of water, eat soft and easily digestible foods such as porridge, soup, and juice, but avoid red-brown foods to detect if gastrointestinal bleeding occurs. . Encourage your child to drink plenty of fluids to avoid thickening of the blood due to plasma loss.

He emphasized, parents need to carefully monitor the time from the 3rd to the 6th day of illness, the child can reduce the fever but easily get worse. If at this time, the child has nosebleeds, bleeding teeth, lethargy, abdominal pain, vomiting, black stools, fatigue, etc. should be taken to a medical facility immediately to avoid shock. This is what makes dengue fever different from other viral or infectious diseases: fever is reduced, but it is still critical.

Also at Children’s Hospital 1 in Ho Chi Minh City, doctors have just saved the lives of 2 children under 1 year of age with severe dengue shock. Both children had high fever for 3 days, on the 4th day the fever subsided but were sluggish, poorly fed, cold hands and feet, pale lips, so the family took them to the doctor.

The children were transferred to the emergency room in a state of cardiovascular collapse, unmeasured blood pressure, enlarged liver, scattered petechiae with concentrated blood. In addition, the child also had severe respiratory failure due to interstitial edema and large pleural and peritoneal effusion supported by continuous positive-pressure ventilation through the nose.

After many days of efforts in treatment, the child passed the critical stage and recovered and was discharged from the hospital.

Linh Giao

A 4-month-old girl has a heart attack due to dengue feverBecause the patient was too small and had severe cardiovascular collapse, the doctors had to give a bone marrow injection and expose the vein to have an emergency line.