Fevers In CCU - page 3

by Nursingbride12

5,213 Views | 28 Comments

I am a new grad in a CCU and we deal with post surgical as well as transplant patients. Needless to say I'm always trying to learn more thing in my position! So my patient has Clebsiella pneumonia following an ECMO... Read More


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    Yes I meant ammonia. My phone autocorrected me
    Esme12 likes this.
  2. 1
    Quote from Sugarcoma

    Hmmm, Tylenol is not used for treating fevers? That is news to me. Almost all of our tylenol orders say prn for pain or fever. We have trouble getting Ibuprofen out of docs, but never tylenol. I wonder if this is an older doc? I remember when my kids were little and had fevers my mother always encouraged rubbing alcohol baths. At one point my pediatrician recommended against it, but I cannot remember why.

    Did the doc recommend the alcohol bath? I only ask because if he ordered the bath to lower the fever what is the difference between lowering it with the bath or with medication?
    Rubbing alcohol needs to be used judiciously, as it can be absorbed systemically. ~Ivanna
    Sugarcoma likes this.
  3. 0
    Nursingbride12-

    We used Tylenol at around temp 101.5 and several hours later at temp 103. At temp 103 I discussed with the PA the possibility of a cooling blanket. She wasn't to keen on the idea since the pt had just been made a DNR and was not expected to make it. (The pt was having long runs of vtach, labs had been checked and were fine, and was In a SIRS state on extremely high doses of levo, neo, vaso barely making bp goals). At temp 103 I give the pt a bath left her skin out in the air, used ice, washed their hair, and gave them some meds to prevent shivering. I checked temp 1.5 hours later and it was 106 we then put the pt on a cooling blanket which took nearly 12 hours to get the temp down past 105.
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    Quote from Nursingbride12
    Yes I meant ammonia. My phone autocorrected me
    That's better.....I would be cautious with alcohol baths or cool baths for they can cause the patient to chill and shiver which will raise the temperature.

    I can see no Tylenol with the ammonia level that high.....but ibuprofen can be used even a cooling blanket.
  5. 0
    You should all try and get orders or IV Tylenol. Ofirmev. I have never seen a patient not drop their temp after that. Amazing stuff. But also cooling blankets, cool wash cloths, ice packs. Turn the thermostat down...
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    Quote from Dodongo
    You should all try and get orders or IV Tylenol. Ofirmev. I have never seen a patient not drop their temp after that. Amazing stuff. But also cooling blankets, cool wash cloths, ice packs. Turn the thermostat down...
    MANY facilities restrict the use of Ofirmev to the pain service and anesthesia staff and it's not used for temperature control because of the costs.
  7. 0
    Quote from meandragonbrett
    MANY facilities restrict the use of Ofirmev to the pain service and anesthesia staff and it's not used for temperature control because of the costs.
    This is correct. In my facility IV Paracetamol is restricted for use by pain team, oncology (as these kids can't have suppositories) and ICU. Unfortunately in ICU we probably give it a bit too quickly over something like a suppository, which is far more cost effective.
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    Thank you for all the advice!!!
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    Quote from imaginations
    This is correct. In my facility IV Paracetamol is restricted for use by pain team, oncology (as these kids can't have suppositories) and ICU. Unfortunately in ICU we probably give it a bit too quickly over something like a suppository, which is far more cost effective.
    You know what, this may be the case where I work, but I'm in the ICU (as are most posters in this thread I would imagine). So I use it often enough.


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