Flu, how to treat children (and adults) without going to the emergency room

Almost a million Italians in bed. The expected impact of flu-like forms, and somewhat feared, is in advance and it is mainly the youngest who are affected. A child’s fever is one of the common reasons for seeking medical assistance, as it identifies the perception of a pathological state which effectively “suspends” the balance of family life. “Some parents may have an unjustified fear of fever when faced with their feverish child. Up to a real one fever phobia» explains the professor Donato Rigante of the “Agostino Gemelli” University Hospital in Rome. Here are some good rules to keep in mind.

A physiological response of the organism

“The term in question (also known in Italy as febriphobia or pyritophobia) was coined in 1980 by Dr. Barton Schmitt and already at the time 50% of parents of feverish children believed that fever could generate permanent neurological damage”, adds l ‘expert. «In some cases, suggestions relating to the control of the fever itself by the doctor may also contribute to fueling this “fear” of fever, not always inspired by shared guidelines, but based on personal considerations on fever or sometimes on erroneous beliefs. This non-one-size-fits-all approach by the physician to the general management of fever may increase parental fears of the febrile child. In reality, it is always advisable to reiterate to parents that fever is a physiological response of the organism which to a very large extent does not generate complications, with the exception of febrile convulsions which, however, are observed in a very limited number of predisposed children”.

Excess controls, the risks

Parents anxious about their child’s fever can present a wide variety of reactions, all dissociated from the understanding (and acceptance of the concept) that fever is a “physiological” response of the body. “Some parents may show concern and end up checking their children’s temperature incessantly; sometimes this form of anxiety becomes a real (totally irrational) terror, above all for an (unjustified) fear that the fever could cause brain damage». Essentially at the heart of these reactions of varying degrees is the erroneous assumption that the child’s increased body temperature represents a disease rather than a potent, very frequent, mostly benign, relatively misunderstood symptom observed in all mammals. as an expression of defense against infections.

What to observe in the child

In the last week the incidence of febrile illnesses has increased in all age groups, but the pediatric ones are more affected and in particular children under five years of age, in which it is equal to 50.2 cases per thousand assisted . Access to the emergency room is not indicated in most cases. “Fever is the first sign of an individual’s innate defenses, through which our body fights many infections (the elevation of one or two degrees in body temperature can really contain and defeat many viral infections),” Rigante points out. What is needed instead is to follow the evolution of the ailment. “At the outset, it is simply appropriate to observe the febrile child at home, as isolated fever does not allow immediate medical recognition of its cause. Above all, the tranquility of the parent must be corroborated if the child feeds, rests, plays and ultimately tolerates temperature changes without apparent great difficulty».

When the hospital is the right option

Before deciding, it is necessary to verify certain conditions indicated by the specialist. “The evaluation of the child in hospital becomes necessary in the case of association of fever with signs that are not easily interpretable (such as weak crying or a state of particular and unusual suffering of the child) or in the event that serious signs of disease appear in the airways ( such as difficulty breathing), the skin (such as haemorrhagic manifestations), the gastrointestinal tract or the central nervous system (such as altered state of consciousness, neck stiffness or any other neurological signs). Even if the fever persists for more than five days, evaluation of the child in the emergency room is required or in cases where it is not possible to guarantee the child a sufficient natural intake of liquids. «Finally, the visit is mandatory a priori in the event that the fever is observed in an infant less than six months old, as the first semester is characterized by marked fragility and it is easy to make errors of evaluation without a check of the child’s clinical objectivity”.

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Flu, how to treat children (and adults) without going to the emergency room

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