SIGNS AND SYMPTOMS OF FEVER

At Blu Sky Care our staff are trained to detect a wide range of SIGNS AND SYMPTOMS that may lead to illnesses that could have an adverse impact on a person’s health. One of these conditions is fever which can have a severe impact on what can considered normal health in a person. Early detection is vital for improved health outcomes.

A fever is when the body temperature rises above 37.5°C. The normal body temperature is between 36 and 37°C, but this can vary from person to person and from hour to hour. A high-grade fever is present when the oral temperature is above 38.2°C. Check with your supervisor or health care practitioner for instructions on what to do about a person with a fever.

If the person is having a fever that has an unknown origin, the caregivers should observe them closely for the development of any signs and symptoms which may be helpful to the doctor in making a diagnosis.

Fever occurs when the body temperature rises above its normal range. As this range varies in individuals, generally, a reading above 37.2C measured in the mouth is considered febrile.

Other signs and symptoms may include the following:

• Flushed face and hot skin
• Headache and muscle aches
• General weakness
• Increased breathing
• Increased heart rates
• Sweating and thirst
• Lack of appetite.

Very high fevers may cause hallucinations, confusion, irritability and even convulsions.

Shivering, chills, and rigors usually follow after profuse sweating in high fever and a sudden drop in body temperature.

Though most fever is part of a virus that will go away on its own, it could also be a signal of serious

underlying diseases. Consult the doctor if any of the following conditions exists:

• Temperature remains at 39C or more in adults, and 38.5C or more in children below age 12 despite
• efforts in bringing down the fever.
• Fever lasts more than 5 days in adults, and more than 3 days in children.
• The signs and symptoms get progressively worse.

You should seek immediate medical attention if a fever is accompanied by any of the following signs and symptoms:

• Severe headache
• Severe swelling of the throat
• Unusual skin rash
• Red, hot, or swollen area of skin C
• Unusual eye sensitivity to bright light (photophobia)
• A stiff neck and pain when you bend your head forward
• Mental confusion
• Extreme irritability
• Repeated vomiting
• Difficulty breathing or chest pain
• Abdominal pain or pain when urinating
• Blood in stool
• Any other unexplained symptoms, such as cough with yellowish or greenish phlegm, earache and severe back pain.

Taking Body Temperature by Mouth (Oral)

The mouth can be a convenient place to test the body temperature. Make sure the person is at rest and that he or she has not just smoked, taken a hot or cold shower, or drunk anything hot or cold. In these situations, the temperature should be taken half an hour later.

WARNING: Very important! Never, ever, use a thermometer orally for anyone who has diminished cognitive capacity or has altered mental functionality.

To take the temperature by mouth, place the thermometer underneath the person’s tongue at an oblique angle.

Ask them to keep their lips closed, not to talk, and not to bite the thermometer. Leave the thermometer in place until the electronic signal sounds.

Measuring the body temperature through the axilla is the safest method because it is non-invasive.

To take the temperature by using the armpit method, dry the skin under the arm with a towel before placing the thermometer because perspiration may alter the temperature of the skin. Place the bulb of the thermometer into the center of the axilla. Bring the arm across the patient’s chest and hold in position until the electronic signal sounds.

Please note: temperature taken under the arm will be slightly lower, so you should make a note of the method used.

Types of Thermometers

There are four types of thermometers commonly used:

• Mercury-filled glass thermometers
• Digital thermometers
• Infrared ear thermometers
• Skin thermometers

Mercury thermometers and digital thermometers can be used to measure body temperature via the

mouth, underneath the arm, or by using the rectal method. Mercury thermometers should be left in place for at least 2 minutes or until the mercury column has stopped rising.

Digital thermometers provide a more rapid reading compared to mercury thermometers.

Infrared thermometers can measure body temperature from the ear.

Mercury/Glass Thermometer

This thermometer is an old standby that has some advantages and disadvantages. Mercury and glass

thermometers are modest in cost and are very accurate. On the other hand, they break easily and pose a hazard from the mercury and broken glass. If you choose to use this method, get the thermometer ready by washing it in cool, soapy water, then rinse and dry. Don’t use hot water because this could ruin the thermometer by causing it to crack. Shake it down by holding the thermometer tightly at the end away from the bulb and shake rapidly using a quick wrist motion. This will lower the mercury in the thermometer. Shake it until the mercury is below 35 C . Some thermometers must be shaken hard. Decide whether to take the temperature in the mouth, under the arm, or in the rectum.

Reading the Thermometer

• Hold the thermometer in good light; rotate it until the mercury line is thickest.
• Each line marks off two-tenths of a degree.

Whenever you are telling your doctor about temperature measurement, be sure to mention whether it was taken orally, rectally, or in the armpit (axillary).

Digital Thermometers

Until recently, mercury thermometers were the only ones available. While more expensive than mercury thermometers, they are safer and easier to use and some are about as accurate.

With most digital types, readings are obtained in a minute or less. The temperature is shown in LCD figures on a display much like on digital wristwatches. Since turning the thermometer off clears the display, you do not need to shake it down. Some come with disposable sheaths which are designed to reduce the spread of infection from one person to another. Using the sheaths with young children is not a good idea because if they slip off in the mouth, the child could choke. Even if the sheaths are used, the thermometer needs to be cleaned by either washing the probe end with cool, soapy water or with isopropyl (rubbing) alcohol.

To get an accurate reading, follow the instructions that come with the thermometer. Made of plastic, the digital thermometers can be used in the rectum, under the tongue, and in the armpit. Check with the pharmacist, because some cannot be used in the rectum. Even though it’s made from plastic, the thermometer can be damaged if it’s chewed on. 

Infrared Thermometers/Tympanic Membrane Thermometers

The newest digital thermometer for home use is also known as the infrared thermometer. Temperature is taken by placing the small cone-shaped end of the thermometer in the ear canal. Heat given off by the eardrum and surrounding tissue is used to calculate body temperature. The thermometer converts the temperature to oral or rectal reading and then displays it on a digital screen. The thermometer gives a reading usually within a few seconds.

Be aware that if the thermometer is damaged, the reading may be incorrect.

Liquid Crystal Temperature Strips

Sold as ‘’thermometers,’’ these plastic strips are made of a substance that changes colour as they warm up. They are inexpensive and easy to use which makes them seem like an easy way to measure body temperature.

These strips are inaccurate because skin temperature is not the same as body temperature. When tested, some were found to be wrong by a degree or more. In some strips, the colours are muddy and hard to read.

Temperature strips are affected by blushing, cold hands holding the strip, a nearby lamp, or a draft from an open window. Conditions like these can affect the reading. The instructions that come with these strips often state that if a fever exists, the temperature should be checked against another thermometer. 

NOTE: You should NOT attempt these methods in your workplace until you have been trained according to the care plan, procedure, and credentialed or assessed and deemed competent to do so. This may be part of a Medication Training Competency plan, so see your supervisor regarding these procedures.