American Medical Association Family Medical Guide - American Medical Association [212]
Taking a temperature rectally
Taking a temperature in the armpit
To take an armpit temperature, remove the child’s clothing above the waist and make sure his or her armpit is cool and dry. Place the thermometer under the armpit and fold the child’s arm across his or her chest, or hold the arm securely to his or her side to keep the thermometer in place. A glass thermometer should remain in the armpit for at least 4 minutes for children under age 2 and for 5 or 6 minutes for children over 2. A digital thermometer will beep when the temperature is registered.
Taking a temperature in the armpit
A fever is seldom dangerous and rarely has any harmful effects. In some children, however, a fever may cause febrile seizures (see page 410). If your child’s fever is lower than 102°F (a low-grade fever) and he or she has no other symptoms, the only treatment necessary may be giving plenty of fluids and rest.
If a child has a fever above 102°F (a high-grade fever), ask your doctor to recommend a fever reducer (such as acetaminophen or ibuprofen). Do not give aspirin to children or adolescents because they can develop Reye’s syndrome (see page 411), a potentially fatal condition. Give your child the medication at regular intervals as recommended by your doctor, but take the child’s temperature before doing so. When the child’s temperature starts to fall, discontinue the fever reducer. If your child is asleep, do not wake him or her; sleep is helpful when you have a fever.
If, after your child has been given a fever reducer, his or her temperature continues to rise and reaches 104°F or higher, call your doctor immediately. If your child has had a previous febrile seizure, make sure your doctor knows.
To relieve discomfort caused by a fever, take the following steps:
• Sponge the child’s face, neck, arms, and legs with lukewarm water, and let them air-dry. Evaporation cools the skin. Do not use a fan, ice, cold water, or rubbing alcohol on the skin to reduce a fever; they can cause shivering, which can raise the temperature even more.
• Keep the child’s room at a comfortable temperature. Do not turn up the heat.
• Dress the child in light, comfortable clothing.
• Do not cover the child with heavy blankets. Using heavy blankets to try to get a child to sweat out a fever can cause his or her temperature to rise even higher.
• Do not let the child get overexerted.
Measles
Measles (also called rubeola) is a highly contagious viral infection that affects primarily the respiratory system. The disease is contracted by inhaling airborne droplets that have been coughed or sneezed into the air by an infected person. Possible complications of measles include croup (see page 420), bronchiolitis (see page 421), bronchitis (see page 655), pneumonia (see page 660), and encephalitis (see page 694).
Symptoms
The initial symptoms of measles include irritability; fever; a runny nose; red, watery eyes; a dry, hacking cough; swollen glands; and, sometimes, diarrhea. In some cases, tiny white spots (called Koplik’s spots) that resemble grains of salt appear inside the mouth. Within about 4 to 5 days, a rash of flat, pink spots (each about inch in diameter) begins to develop, first on the forehead and behind the ears, and then on the face, neck, trunk, arms, legs, and feet. A few days after it appears, the rash begins to fade and the fever breaks.
Some children