Reasons NOT to give APAP for fever?

Published

Specializes in Med/Surg/Tele/SNF-LTC/Supervisory.

I've heard of the pre blood culture holding of the apap.. but are there other instances when you would not give tylenol?

Would you only give tylenol for a low grade fever IF the patient felt the fever uncomfortable?

Thanks all.. = )

Up Vote Up Vote ×
Specializes in Med/Surg/Tele/SNF-LTC/Supervisory.

Error.. not low grade.. but actual fever, over 100.4 F

Up Vote Up Vote ×
Specializes in psych, addictions, hospice, education.

apap=tylenol? I haven't heard it called that, or I've forgotten, or I'm confused...

I don't know the reason for withholding it before blood cultures and would like to know!

Up Vote Up Vote ×
Specializes in Oncology.

We don't give it in our BMT patients unless they're a child or the temp is very high. Letting them have a fever is one of the only defenses their body has naturally against bacteremia. The bacteria don't tolerate the higher body temp as well and die more easily. Also, we don't want to mask the fever. Left untreated, the fever can be a good indicator of if the antibiotics are working, especially in someone who otherwise feels decently and isn't obviously septic.

Up Vote Up Vote ×
Specializes in psych, addictions, hospice, education.

ok...that's the reason for withholding it with a fever, but why withhold for blood cultures?

Up Vote Up Vote ×
Specializes in Oncology.
ok...that's the reason for withholding it with a fever, but why withhold for blood cultures?

Wasn't that the question? I've never heard of withholding it for blood cultures. Waiting on giving antibiotics, yes, tylenol, no.

Up Vote Up Vote ×
Specializes in Emergency.

Back in the day, I was always told to draw the BC and then give the tylenol. They said that the bacteria were more active and you had a better chance of "capturing" the organism. I'm not sure if this holds true for most fevers today, excepting those diseases with typical fever patterns, like Malaria,or drug fevers. (of course for both Malaria and Drug fevers, the BC may well be negative, as Malaria is found on a smear, and the drug fever will stop only when we stop the offending drug.

In cases that do have a recurring fever pattern, you can time Blood Cultures as the bacteriologic burden is highest in the blood stream about 1 hour prior to fever spiking. But for the most part for a typical say, ICU pt in the US, you won't know exactly when he is going to develop a fever. And the majority of them do not develop fever patterns that are useful or diagnostic.

Did that help or further muddy the water?

Up Vote Up Vote ×
Specializes in psych, addictions, hospice, education.

ah hah! thank y'all...

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.

I wouldn't give APAP (I use that term in my notes, BTW) if the patient has a hepatitis or other liver dysfunction/failure. At least it wouldn't be my first choice.

Up Vote Up Vote ×
apap=tylenol? I haven't heard it called that, or I've forgotten, or I'm confused...

FINALLY - one I can answer! :lol2:

APAP = acetaminophen = Tylenol. The APAP abbrev is usually used when it's in combination with another medication (ex. Hydrocodone/APAP - beloved of seekers everywhere); tend to see it a lot in pharmacies. Learned it well when I did my Pharmacy Tech internship - Hydrocodone/APAP was far and away the most filled prescription at the CVS I was assigned to.

----- Dave

Up Vote Up Vote ×
Specializes in ICU, ER, EP,.

no, tylenol has no effect of the actual bacteria that may or may not exist in the blood stream when collecting cultures.

Tylenol is an antipyretic and combats the effect of the bacteria and the bodies response to the insult to it.

Tylenol does not kill, diminish of affect the actual bacteria in any way in the blood stream and does NOT, NOT affect blood cultures.

Giving Tylenol and lowering the bodies temperature and ability to fight infection does affect the over all outcomes though and is not given by my hospital until a temp hits 103. Allow the body to fight....

Up Vote Up Vote ×
+ Join the Discussion