Is it a good idea to use "iced pull-up pants" to reduce children's fever? You must know these 5 points about physical cooling!

"Pour some water into the pull-up pants and put them in the refrigerator. Cover your head with them at night. They have a good fever-reducing effect."

Image source: Internet

This picture has been widely circulated online, and many people must have seen it!

I have to admire the wisdom of the Chinese people: it saves money, is easy to obtain, convenient, can be used repeatedly, and reveals an optimistic spirit in fighting the epidemic.

However, this cannot help but cause concern: although it is good to make use of folk wisdom, it also needs a little scientific support to avoid causing big problems.

01

What is a fever and why do we need to reduce it?

First, a fever is a sign of illness, usually because the body is fighting an infection.

If a baby under 6 months old has a fever, it is not recommended to treat it yourself, please seek medical help.

Secondly, there must be a reason for a fever, and the reason itself is more important than the symptoms of a fever.

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Therefore, we will see that doctors often recommend that before the cause of the disease is known, if you are not feeling particularly uncomfortable, try not to use antipyretics, for fear that the medication may mask the condition and make diagnosis and treatment unfavorable.

However, under the premise that the cause of the disease is clear, reducing fever can help the patient/child feel comfortable and maintain a certain level of energy and physical strength to live and work.

If your body temperature is high but eating, playing and sleeping are not affected, there is no need to reduce the fever.

It is worth mentioning that reducing fever is not a cure. Therefore, during the course of the disease, it is normal for the body temperature to rise again after the fever has subsided.

02

Physical cooling and drug cooling

Physical cooling is introduced in many popular science books and related books for doctors, and is still recommended in tradition, such as cold compress, warm water/spa bath, ice patch, warm water foot bath, etc.

The principle is to take away body heat. It is cheap and (seemingly) safe, but its effect lasts only a short time.

However, the most effective scenario for physical cooling now is to use it on patients suffering from heat stroke, or to use it in combination with drug cooling, or when there are really no drugs available.

Drug-induced fever reduction is an increasingly accepted method of reducing fever.

The most commonly used ones are ibuprofen and acetaminophen, which not only reduce fever but also relieve pain.

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When taking the medicine, you need to follow the doctor's instructions or instructions and refer to the patient/child's weight.

Remember to drink plenty of water while taking the medicine, because you may sweat a lot during the fever-reducing process, especially for the weak and infants. Drinking plenty of water can help avoid dehydration, electrolyte imbalance and other problems.

Children with viral infections are at risk of developing Reye's syndrome (RS) if they take aspirin, so countries such as the United Kingdom and the United States have emphasized that infants, children or adolescents with fever should not take aspirin.

03

Limitations of physical cooling

Okay, now it’s time to knock on the blackboard.

I said earlier that physical cooling "seems" safe. This is because many people do not actually know how to perform physical cooling correctly, and they also ignore some problems in the physical cooling process.

If the same problem occurs while taking medicine, everyone will think "Is it a side effect of the medicine?", but it is ignored during physical cooling.

In fact, if physical cooling is not handled properly, it may cause big problems.

The following 5 points must be paid special attention to:

1. Physical cooling is traditionally recommended using 32-35℃ warm water.

However, if the patient is in the fever stage and the water temperature for physical cooling is relatively low, the patient will shiver. Shivering will be accompanied by constriction of blood vessels in the skin, and the body will increase heat production and reduce heat dissipation, which will cause the body temperature to rise further. [1]

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In other words, improper use of physical cooling will increase discomfort and affect the fever-reducing effect.

2. When using physical cooling, do not wipe the precordial area, abdomen, back of the neck, and soles of the feet, because these areas are sensitive to cold stimulation and may cause reflex slowing of the heart rate and diarrhea.

3. It is generally not recommended to use alcohol for physical cooling. There was a case where a family member used 75% medical alcohol to wipe the patient to reduce fever (undiluted alcohol) while the patient was taking antibiotics after surgery, which caused the patient to have a disulfiram-like reaction. [2]

4. Infants, children, patients with blood diseases, and patients with skin injuries are prohibited from wiping with alcohol.

5. Physical cooling is also prohibited for those with cold limbs and whole body. Such patients need to use medication to cool down and pay attention to keeping the body warm.

04

Put an ice cap on a child with a fever

Are you serious?

The popular ice pull-up pants are really "folk wisdom" because they are very similar to the "ice cap" used in medicine. However, I strongly advise against this.

Ice cap is a local hypothermia treatment suitable for patients with craniocerebral injury, cerebral edema, etc. It can reduce brain tissue metabolism, reduce oxygen consumption, prevent or alleviate cerebral edema, and facilitate the recovery of brain cell function.

However, it will not be used for other patients in clinical practice, especially those with weak constitutions or pregnant women. During use, it is also necessary to prevent cyanosis, numbness and frostbite, and observe changes in the head skin, especially the auricle.

A fever may be cured in three days, but frostbite is troublesome and difficult to treat by yourself, so you have to go to the hospital.

05

in conclusion

Fever is not a disease, and it is not scary. You can use methods that make you feel comfortable to reduce the fever. (For infants under 6 months old, please see a doctor)

Drug-induced fever is achieved by reducing the excitability of the body's temperature regulation center and promoting heat dissipation through methods such as vasodilation and sweating. It is effective and rapid and can reduce the child's discomfort. [3]

When medication is not available for cooling, physical cooling can be used, but you must pay attention to safety to prevent secondary injuries from physical cooling.

If you really want to try freezing pull-up pants, you can do it for fun, but you must pay attention to prevent frostbite. At the same time, please do not let people with weak constitutions and pregnant women try this method.

References:

[1] “A study on the effect of physical cooling on fever in infants and young children during emergency treatment”, Qian Xiuling, Wang Zhiyong, Guo Yuhua

[2] “A case of disulfiram-like reaction caused by alcohol bathing after intravenous ceftriaxone infusion”, Hainan Prefecture People’s Hospital, Qinghai Province

[3] "Clinical Common Nursing Skills Scenario Simulation", 2019, People's Medical Publishing House

Author: Dr. Yunyun Xu

Review｜Zhang Lujie, deputy chief physician of pediatrics

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