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Fever in a child: what to do and when to call

Fever itself is not the enemy — it is how the body fights infection. What matters is not the number on the thermometer but how the child looks: a child with 39 °C who drinks and plays is safer than a lethargic child with 38 °C. Treat the child, not the thermometer.

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What to do right now

Undress and give fluids
Light clothing, room at 20–22 °C, drink every 10–15 minutes — water, weak tea, rehydration solution.
Medicate above 38.5 °C, or lower if the child feels bad
Paracetamol 10–15 mg per kg or ibuprofen 5–10 mg per kg. Not more often than every 6 hours for paracetamol and every 8 for ibuprofen.
Never aspirin
Aspirin in children with a viral infection can cause Reye’s syndrome, a life-threatening liver and brain condition.
No vodka or vinegar rubs
They are absorbed through the skin and poison the child. Cool water sponging is acceptable.
Watch behaviour, not the thermometer
Drinking, responding, urinating every 4–6 hours — good signs. Lethargy, refusal to drink, no urine for 8 hours — call.

Call an ambulance if

Any fever in a baby under 3 months
Fever with a rash that does not fade when pressed with a glass
Seizures, loss of consciousness, uncontrollable crying or unusual drowsiness
Refusing to drink, vomiting everything, no urine for 8 hours
Difficult or rapid breathing, grunting, retraction between the ribs
Fever above 39 °C that does not come down after medication
Fever lasting more than three days

What not to do

Do not wrap the child in blankets during fever
Do not give aspirin or analgin to children
Do not use alcohol or vinegar rubs
Do not give antibiotics without a doctor — they do nothing for viruses

What the crew does

Examination, temperature, oxygen saturation, chest auscultation, throat and rash check
Rapid tests for influenza A/B and streptococcus — 15 minutes
Injectable fever medication, infusion for dehydration, inhalation for croup
Admission if needed to a paediatric hospital — in Moscow these are Morozovskaya, Filatovskaya, St Vladimir, Bashlyaeva and Speransky hospitals

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

Should I be afraid of febrile seizures?

They occur in 2–5 % of children under five and usually last under 5 minutes. Put the child on their side, do not put anything in the mouth, note the time and call. Any first seizure requires examination.

How much does a paediatric call-out cost in Moscow?

Call-out 6,000 ₽ inside the MKAD; a specialised paediatric crew is 15,000 ₽. Tests, injections and infusions are charged by the price list.

Do I need to bring the fever down at all?

Only if the child feels bad or the temperature exceeds 38.5 °C. A comfortable child with 38.2 °C does not need medication.