Aug 12, 2016

Interviewer: When is a fever bad enough that y'all should become to the ER? We'll examine that next on The Scope.

Announcer: This is "From the Frontlines," with emergency room physician Dr. Troy Madsen, on The Scope. On The Telescopic.

Interviewer: Dr. Troy Madsen is an emergency room physician at University of Utah Health Care. When is a fever bad enough to go to the ER? Dr. Madsen, shed some light on that for us.

Dr. Madsen: Yeah. Yous know, it'south interesting yous bring that question up considering I've had people ask me even recently. They've said, "At what point is the fever only going to cook my brain and how high does it take to be to cook my brain"?

Interviewer: That tin can't happen. Right?

Dr. Madsen: I can't say I've ever seen it happen and I told them that.

Interviewer: Okay.

Dr. Madsen: And it'south something that's out there. I remember hearing that too, like people saying, "Wow, you got to continue your fever down, or you're only going to fry your encephalon." I tin't say I've seen that. So when I think of fever I don't think of the absolute number with the fever. We define a fever as being 100.5 degrees Fahrenheit or greater. So I retrieve of fever more in terms of what are the symptoms that yous're having or what kind of medical problems do you have.

This is a child, a immature infant, less than, say, 12 weeks old, and they have a fever of 100.5 or greater, you got to go to the ER considering in that location, we get concerned about a serious infection. If this is someone who has an immune system trouble, who'south on chemotherapy, or perchance has HIV, or something that's affecting their immune system, again, some other reason to get to the ER. I'grand not concerned about is information technology 105, is it 100.5, if they have a fever, they need to have testing washed.

Interviewer: If they are in that particular group?

Dr. Madsen: Exactly.

Interviewer: Okay.

Dr. Madsen: If they have allowed system problems, if they're very immature, and then, of course, if they're very one-time, people who are very old also. It's interesting considering very old people really don't get loftier fevers like someone in their 20s might. So in them, a fever or a temperature of 100.5, that'southward pretty meaning. And again, potentially a sign of something going on that's very serious. Whereas the average person walking along, who'southward healthy, who has really no medical bug, mayhap they have a cough, maybe they have a fever upwards to 102, even 103, in my listen, that's not so apropos.

Then when I call up of fever, I recall of more the whole person, what kind of medical problems do they take. And so, beyond that, I think of "Okay, what else is going on?" If it's someone who has a fever, who says the light bothers my optics, my neck is stiff, I'm confused, or someone is reporting to me that they're dislocated, then I recall of meningitis. Fever with a really severe cough, or a coughing that has been going on for a calendar week, and won't go abroad, I think of pneumonia or a sinus infection. Certainly, fever is with your unary symptoms, back pain, we think nigh kidney infections and problems there.

And so once more, you're taking that whole picture. So I think the large take home point would exist that I don't even own a thermometer at home. I don't check my own temperature. I know if I'1000 hot, or I'm cold, or family fellow member is hot or cold. I've heard some pediatricians say, "Go rid of your thermometer. Just don't use information technology on your kids unless they're the very young kids less than 12 weeks old," Because in that location, you are again looking at the whole picture. It's non just the fever.

Is the kid lethargic? Are they feeding well? Are they eating? Are they withal urinating, meaning that they're nevertheless having adequate fluids in their trunk? You're looking at everything there in addition to the fever.

Interviewer: That'due south kind of a tough paradigm for me to wrap my head effectually considering I think a lot of people are merely driven by "Oh, 103 fever. That's called-for upward. That's a major problem." Merely it sounds like you're saying to take that every bit an indicator to maybe appraise, are there some other problems going on and those other issues are really the reasons why you'd probably become to the ER?

Dr. Madsen: That'south exactly it. You could accept 103 fever with kind of a run of the mill cold, and you could feel absolutely miserable, merely information technology doesn't hateful you have to blitz to the ER.

Interviewer: Okay.

Dr. Madsen: And you lot can. If you're at all concerned, never hesitate to call your doctor. Never hesitate to go to an urgent intendance or an ER. But in your listen, I desire to recall of information technology as similar, "Okay. This absolute temperature means you're sick or something less than temperature means you're non." Similar I said, some people with 100.5-caste temperatures who have other issues, that's really serious. Whereas another person on 103-degree temperature, probably very well, but could be a viral infection, and it isn't that big a deal.

Interviewer: So this could be probably tough data for somebody to hear because I'm imagining if they're listening to this, they're concerned about somebody in their life with a fever. If they don't autumn in one of those two groups, the very young, the very old, they're going to want to practice something. Only information technology sounds like what you're saying is a fever should only indicate that maybe you should look and encounter if at that place are other symptoms?

Dr. Madsen: That's exactly it.

Interviewer: Yep.

Dr. Madsen: Aye. I won't rush to get into the hospital based on a fever alone. Look at the whole motion picture. Look at all the symptoms. Await at how the person is acting. If they're acting fine, and they're eating well, and drinking well, and they're warning, and they're not confused, and they've got a temperature of 102, they're probably okay. You can give information technology some time. Y'all can take some Tylenol, some ibuprofen, to bring the fever down and run into how they're doing.

Journalist: Nosotros're your daily dose of health, sciences, conversation. This is The Telescopic, University of Utah Health Sciences Radio.

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