Fevers In CCU

Specialties CCU

Published

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 de-canulation and continues to have a fever of 103. I've already given Tylenol and want an order for something else so my patients fever doesn't get even higher.

Call doc on infectious disease following them and the doc says that they are not going to treat a fever. That its the bodies reaction and needs to be that high. They'd actually rather me not even give the Tylenol because the Tylenol should just be used for analgesic use and not for fever when the patient is incubated and on IV meds for pain.

My preceptor and I were very surprised by this little lesson and I want to know if anyone else has had experience with this?? Or any other experience with docs like this?

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...

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.

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.

Specializes in Cardiac, Transplant, Vascular, NICU.

Thank you for all the advice!!!

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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