Antipyretics Tylenol vs Ibuprofen in Pediatrics

[TlhRNED]

Our pediatricians in my facility are pushing for our ED to start an initiative for patient/parent education on the effects of alternating or combining Tylenol and Ibuprofen in the Pediatric population. They do not want us treating all fevers and educate parents as to the reasoning- can you see the Press-Ganey scores now! :roll

I am attempting to write a fever protocol- can you imagine the difficulty with so many differing opinions??? Any input out there?

[MAGIK GIRL]

i like tylenol and then motrin. you can give the tylenol in shorter increments. also give tylenlol and check the temp in 45 min and then give motrin.

i have worked in er's that use either or but i find the most of the time tylenol works the fastest but works the best in conjunction with motrin.

[mercRN]

It depends on how high the temp is where I work at. If the temp is below 102 we usually give tylenol unless the parents actually gave them some within the last 4 hours. For temps over 102 we start with Motrin unless it had been given within the last 6 hours. Our docs alot of times if we give tylenol or motrin in triage to a pt and the temp is still up when they see them, approx 30 min if we are lucky, they will order us to give the other. Do your hospitals do that? I was always told 2 hours between but they don't seem to think so.

I know at our small community hospital where my sister in law works at, one of the peditricians doesn't want his patients medication for temp, no matter how high it is. He said that the temp is fighting infection and wants the temp to stay up. I don't think it is right, but who am I to say I am just a nurse. :)

[RainbowSkye]

Please check out the fever information by Dr. Barton Schmidt; your docs are right on the money about fever being helpful in fighting infection.

100°F to 102°F Low-grade fever: Beneficial. Try

(37.8°C to 39°C) to keep the fever in this range.

102°F to 104°F Moderate-grade fever: Beneficial.

(39°C to 40°C)

Over 104°F High fever: Causes discomfort, but

(40°C) is harmless.

Over 105°F High fever: Higher risk of

(40.6°C) bacterial infections.

Over 108°F Serious fever: The fever itself can

(42°C) be harmful.

Here's a link you can check out: http://www.med.umich.edu/1libr/pa/pa_feverpho_hhg.htm

There has been some research that shows treating fever can increase the length of an illness by a couple of days.

[mercRN]

Originally posted by RainbowSkye

Please check out the fever information by Dr. Barton Schmidt; your docs are right on the money about fever being helpful in fighting infection.

100°F to 102°F Low-grade fever: Beneficial. Try

(37.8°C to 39°C) to keep the fever in this range.

102°F to 104°F Moderate-grade fever: Beneficial.

(39°C to 40°C)

Over 104°F High fever: Causes discomfort, but

(40°C) is harmless.

Over 105°F High fever: Higher risk of

(40.6°C) bacterial infections.

Over 108°F Serious fever: The fever itself can

(42°C) be harmful.

Here's a link you can check out: http://www.med.umich.edu/1libr/pa/pa_feverpho_hhg.htm

There has been some research that shows treating fever can increase the length of an illness by a couple of days.

Thanks alot. Have to take this to work to show the docs. :)