 As an emergency medicine physician, one of the most common things I see in the emergency department are sick children, especially children with fevers. Fevers are usually the calling card of simple viruses causing colds. However, a fever may indicate an illness requiring a physician's care. The purpose of this instructional videotape is to provide the basic understanding of how to recognize and treat a fever at home and when to recognize it is time to see a physician. I think she has a fever. What do you want to do? What should we do? What is a fever anyway? How high is too high? And what medicines can you give your child? When should you go see your doctor? Let's take a look. Fever most commonly occurs is a response to an infection. During infections, moderate fever is probably beneficial because it enhances the body's defense reactions. Any high temperature or rapidly rising temperature not well controlled with medicines can be a sign of serious infection. About one fourth of pediatric patients who visit the emergency department have a fever as a sign or symptom. The vast majority of these patients have simple illnesses caused by viruses that go away on their own after a few days. Some result from bacterial infections that can be treated at home. Antibiotics like penicillin and amoxicillin kill bacteria. These antibiotics do not work against viruses. If the fever is caused by a virus such as the flu, chicken pox, or a cold, the best thing to do is to give plenty of fluids, maintain fever control with fever medicines, and let the virus run its course. So, what is the best way to take a child's temperature? There are a variety of ways to measure body temperature. If your child is less than three years old, erectile temperature is the most accurate. However, skin temperature from the armpit are easier to do at home with less risk of hurting the child. Oil temperatures are appropriate for children older than four years. Newborn children less than one month old do not get a fever from illness the way older children do. These newborns react to illness with poor feeding, inconsolable crying, difficulty breathing, or just plain do not look well. Any newborn child with these symptoms should be evaluated by a physician immediately. Any temperature greater than 100.4 degrees in a newborn child should be evaluated by a physician. Children between the ages of one and three months with temperatures greater than 100.4 degrees despite giving fever medicines should also be evaluated by a physician. Any child three months to three years old with a temperature greater than 102.2 despite medicines and fluids should be evaluated. And any child with a temperature greater than 105 degrees should be taken to a physician immediately. Now that you've determined your child has a fever, what can you do about it at home? One of the most important things is to ensure your child drinks plenty of fluids. In the newborn, that means breast milk or formula or an electrolyte fluids that is specifically made for infants. In the older child, juice, water, or sports drinks are the best fluids to give. Deluding the juice is important and may ease an upset stomach caused by too much sugar. This will help prevent vomiting. So, what medicines should you give your child to control a fever? There are many different brand name fever medicines on the market. There are two basic generic types, acetaminophen and ibuprofen. Look at the ingredients and dosage recommendations on the box or bottle. Read the labels carefully as many different brand names are the same medicines. Acetaminophen is an effective anti-fever medicine. Follow the dosage labels carefully. Ibuprofen is another powerful anti-fever medicine. If one does not work well by itself, then both can be given at the same time and work very well together to bring a fever down. Again, it is important you follow the directions carefully. Another effective way to bring a temperature down is a tepid bath or sponging with cool water. Do not bathe a child in cold water or ice water and never sponge a child with alcohol. Bathing or sponging should be combined with fever medicines. One note about medicines. Never give aspirin to a child with a fever as it is associated with liver and nervous system complications. So, when should you bring your child to the emergency department? First, try to contact your child's pediatrician. As stated earlier, any child less than one month old who appears ill should be taken to a physician immediately. If you are unable to contact a pediatrician right away and your child has a fever, here are some general indications of when to bring your child to the emergency department. A fever that remains high despite fever medications. If the child does not drink fluids or is vomiting everything up. Shortness of breath or irregular breathing. A cough and a fever together. If the fever lasts longer than four days. If the child does not want to move his head or if his neck hurts. And any child less than three months old. Just think how you feel when you get a cold or a flu. Miserable. And that's how your child feels. The important thing is you know how your child acts when he or she gets a cold or a flu. Follow the important steps of giving plenty of fluids and proper fever medicines. If your child does not get better after a few days or has one of those previously mentioned complications and most importantly if your child looks different or worse than their usual cold and flu self then take your child to a physician immediately. The video you just saw focused upon common medical problems often encountered in an emergency department. Many of these problems can be managed by primary care physicians such as family practitioners, internists and pediatricians and others. As a first step towards managing your healthcare we urge you to contact your primary care physician as they are typically acquainted with your medical history and can maintain continuity in your care. If you do not have a regular physician we strongly encourage you to establish a relationship with one.