Nurses’ management of fever in children: rituals or evidence-based practice?



In most instances when children have had febrile convulsions, they are admitted to hospital (Morgan, 1991), and once admitted the patterns of their body temperature and other symptoms will be monitored and managed by medical and nursing staff in order to establish a cause for the convulsion. Febrile seizures are extremely distressing for parents (Addy, 1991; Balslev, 1991; Monsen et al., 1991), and management is often concerned with the prevention of a recurrence, which, if it should happen, is not necessarily harmful to the child (Hunter, 1973; Ellenberg and Nelson, 1980; Neville, 1991; Ross, 1991; Bethune et al., 1993). Management strategies often include pharmacological treatment of the fever using antipyretics such as paracetamol (acetaminophen) or ibuprofen. Among physicians and nurses, the rationale for this procedure appears to be that fever is deemed harmful and should be treated, because antipyretics are thought to provide comfort to a child and prevent febrile convulsions, and finally, because parents often expect to see some treatment administered, usually in the form of medication, for their child (ElRadhi and Carroll, 1994). Despite research findings that support the positive immunological and diagnostic role of fever (Hull, 1991; Kluger, 1995), and that argue against the use of antipyretics, ElRadhi and Carroll (1994) state that the reality in practice appears to be their continued liberal use.


Febrile Seizure Febrile Convulsion Febrile Child Endogenous Pyrogen Thermoregulatory Centre 
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