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Dr. Folz PediatricianMy Baby has fever, what would the Pediatrician do?

As a pediatrician, one of the most common questions I receive when parents call me during the evening or on weekends is: “My baby or child has a fever of 103 degrees, should I take them to the emergency room?”  Generally, my first question is that it depends how the child is acting.  Most of the time no ER visit is necessary for the fever but we need to determine whether the child is dehydrated and might need IV fluids.

Dehydration is a serious pediatric medical issue and requires immediate intervention.  If we do not consume enough liquid, then vital bodily systems such as our kidneys will stop working.  It is important to understand that the longer it takes before receiving fluids, the more time and effort it will take to get rehydrated.

Fever and Dehydration Defined

Fever is the body’s response to an infection and actually is beneficial for an otherwise healthy child or baby.

Treating the fever with acetaminophen or ibuprofen will not directly help with the dehydration.  However, most times, by treating the symptoms we make the child feel better and it is easier for them to consume (and digest) fluids and food.

Dehydration is when the body uses more fluids than a person consumes and is generally quite dangerous for children and adults.

Causes of Dehydration

Vomiting

Diarrhea

Unable to consume fluids because of fever or other discomfort.

Excessive sweating (common with athletes or children with high fever)

Symptoms of Dehydration

General symptoms for parents to observe include: How is the child acting?  Is the child eating?  Is the child consuming liquid?

Detailed symptoms for parents to observe include: the child playing normally or are they lethargic?  Is the child interacting with you or are they withdrawn?  If you press on the top of their fingernail does the nail remain white or does the color come back?  Is their mouth moist or dry?  Are they making tears?

Treatments for Dehydration

Mild dehydration can be treated by consuming flavored liquids (plain water tends to upset the stomach) such as popsicles, diluted juice, Pedialyte, or Gatorade.

Advanced dehydration is treated by administering fluids intravenously.

Where to Receive Treatment for Dehydration

All Better Pediatrics during clinic hours for assessment and to receive IV fluids.

Urgent Care Clinic during evenings for assessment.

Hospital Emergency Room during evenings for assessment and to receive IV fluids.

All Better Pediatrics is one of the only pediatric clinics that can administer IV fluids on site.  The benefit of receiving IV fluids in our office is that you do not have to incur the hassle or the expense of being treated in an emergency room.  Who wants to drive all the way from Memphis, East Memphis, Germantown, Cordova, Bartlett, Lakeland, Arlington, or North Mississippi to sit in an ER and wait to be seen!

Case Study of Dehydration

Addressing dehydration early is important to assure a quick and healthy resolution.  When my daughter Sarah was 2 she became quite ill with vomiting and diarrhea one night and we tried in vain to have her consume fluids.  After about 48 hours we decided that she was dehydrated to the point that we needed to bring her to the ER.  Sarah had become so dehydrated that she not only need IV fluids in the ER but was admitted to the hospital and received fluids for the next 2 days until she was ready to be discharged.  The hospital bill was about $3,500 and, like most everyone else, we don’t have very good insurance.

When we were driving home from the hospital our friend, who was caring for Abby while Jim and I were at the hospital, called and said that Abby was starting to have vomiting and diarrhea.  For the next 12 hours we treated Abby with fever control and fluids but she was not improving so we brought her to the office.  An IV was administered at the office and Abby was pretty much her normal self by noon that day.  We even had to run out and buy her McDonalds for lunch.  Total cost about $254.  ($250 for the office visit and fluids + $4 for the happy meal when she felt better.)

It just goes to show, an ounce of prevention is worth a pound of cure.

Healthcare for kids.  Helpcare for parents.