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Discussion

Tx of neruologic fever

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I usually try nonpharmacological means 1st...such as ice packs, cooling blanket, or fan. If that doesn't work....tylenol, ibuprofen.

we use a hyperthermia machine (cooling blanket -this thing circulates cold water through a 'blanket' -most machines can accomodate two or three of these blankets -depending on the severity, typically our patients only have one under them (under the bedsheet -never let such a thing remain in direct contact with skin on penalty of damage to the skin) but can have one on top as well. The machine monitors the patients' core temp with a rectal probe -you set the desired body temp, and the machine does the rest (you can set it to be very agressive (cool rapidly) medium or mild. I generally find medium to be the best -no point in inducing shock after all, and mild never really seems to do the job).

When setpoint is reached, the machine will 'idle' to maintain the temp -though to test and see if the patient is going to stay within range, we usually turn it to 'monitor' mode and it shuts off everything but the temp monitor.

Used properly, these are very handy machines to have.

If a patient have a high fever due to brain injury, how do physicians treat this?

sometimes if its truely neuro in origin pts wont respond to pharmacological methods. Cooling blankets...ive seen pts paralyzed to prevent shivering.

Out of curiousity are there an IV drugs that can be used as antipyretics?

I've heard that Toradol can work as an antipyretic, but I've never seen it used as a treatment for fever alone.

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