The Pharmacist September/October 2018 - Page 46

VIEWS Stop getting hot under the collar over mild fevers Health professionals and the public need to learn where fevers are not dangerous, says GP Dr Livingstone T Dr Livingstone is The Pharmacist’s GP blogger his is a brief story of fever, anxiety and misinformation. It also provides an insight into why the NHS is so busy and short of cash. A mum phones 111 about her feverish child and is directed to the out-of-hours centre. She’s worried because her other daughter once had a febrile convulsion. She’s given advice about fever control. She visits the pharmacist to stock up on paracetamol. Her child’s fever doesn’t seem to improve. The next day she attends A&E and is lectured on the importance of getting the temperature down and ibuprofen is advised. She goes to another pharmacy. Next day, the child is still febrile and ends up in my Monday morning emergency surgery. The child is four years old, a bit sniffly and well enough to dance around my room trying to stick her hand in my sharps bin. Mum looks on, a picture of anxiety, commenting: ‘She still has a fever’. And so she has. Of 37.8°C, obtained in the few seconds she keeps still before resuming her blitz. By this point, this child has seen five health professionals and spent many hours oscillating between 111, emergency primary care centre, pharmacies, A&E and my surgery, and all the while has been manifestly well. This scenario could have been sorted with one consultation. Yes, the mum’s anxiety played a part, but no one had allayed it. If one health The child has professional had said: seen five • You do not need to ‘fight a fever’ • Fever is normal in a viral infection separate health • The only relevant issue is ruling professionals and all out a serious cause for the fever, the while has been which was clearly not a concern here as the child was so well manifestly well • Current guidance is only to use paracetamol or ibuprofen if the child is unwell or distressed, not just for the fever itself • Anti-pyretics do not prevent febrile convulsions which, though distressing, are harmless Explaining this took a bit of time, largely to unravel all the previous advice. So before we blame the public for creating unnecessary work, let’s get our own facts straight. Then Monday mornings might be less febrile. More online from The Pharmacist bloggers • Léa Legraien Why I’m reconsidering my stance on homeopathy • Editor’s comment: Beth Kennedy The unsuccessful cuts appeal is a bitter pill to swallow – but there is still hope 46 | The Pharmacist | September/October 2018 • Dr Livingstone Why it sometimes pays to ignore NICE guidance FOR MORE BLOGS For the latest opinions, visit