Rising hospital admissions

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c636 (Published 02 February 2010) Cite this as: BMJ 2010;340:c636

Doctors and nurses have to stop advising 'to control' the temperature in fever

Doctors, nurses and NHS Direct are still advising 'to control' or 'to manage' the temperature in a fever. This is despite decades of medical literature indicating that this is not needed and the 2007 NICE guidance on feverish illness in children. 1

Health professionals should explain to parents that in a normal fever process the body is heating itself up from the head, thorax down into the hands and feet. Ask yourself the question, what do
you do when you feel cold and shivery (and already having a raised temperature) you wrap up to support the body to heat itself - into the hands and feet. As such these are cold as compared to the upper body when the body has not achieved this aim yet.

Once the body has managed to heat itself including the hands and feet, the fever process settles down - circadian rhythms. It is amazing that doctors are subjecting children to draconian measures to prevent the
body to heal itself, it is amazing that they let these children suffer and shiver and leave parents in a state of perpetual worry - as parents of course realise that you can not 'control' or 'manage' the temperature in a feverish child. Why do you think that these children keep crying?

Parents should be advised that they can put in a complaint when given this outdated advice of 'temperature control' and when they have not been informed on what to expect in a normal fever process and how to support this. Of course this outdated 'lower the temperature' advice is resulting in a financial burden for the health service because of admissions due to 'parental concern'. (BTW parents should be explained that if their child gets stripped and fanned on a paediatric ward that they can put in a complaint as well).

1) Havinga, W. In the interest of the public. http://www.bmj.com/cgi/eletters/337/sep02_2/a1409#2023

Competing interests: e-book http://www.everyday medicine.com/fever.htm

Competing interests: No competing interests

09 March 2010
Wouter Havinga
Family Doctor