Episode 970: Fever Management

Episode 970: Fever Management

Contributor: Aaron Lessen, MD

Educational Pearls:

Recorded March 2025

What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two?

  • The journal Pediatrics aimed to answer this question with a meta-analysis of 31 randomized controlled trials including 5,009 febrile children.
  • Results showed that both combined and alternating acetaminophen/ibuprofen regimens were significantly more effective at reducing fever at 4 and 6 hours compared with acetaminophen alone, with numbers needed to treat (NNT) of 3 and 4, respectively.
  • High-dose ibuprofen alone also offered modest benefit (NNT 8).

What dose should I use?

  • Oral acetaminophen
    • 10 to 15 mg/kg
    • Every 4–6 hours as needed
    • Do not exceed 75 mg/kg/day (or 4,000 mg/day maximum for older/larger kids)
  • Oral ibuprofen
    • 5 to 10 mg/kg
    • Every 6–8 hours as needed
    • Do not exceed 40 mg/kg/day (or 2,400 mg/day maximum for older/larger kids)

References

  1. De la Cruz-Mena JE, Veroniki AA, Acosta-Reyes J, Estupiñán-Bohorquez A, Ibarra JA, Pana MC, Sierra JM, Florez ID. Short-term Dual Therapy or Mono Therapy With Acetaminophen and Ibuprofen for Fever: A Network Meta-Analysis. Pediatrics. 2024 Oct 1;154(4):e2023065390. doi: 10.1542/peds.2023-065390. PMID: 39318339.

Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4

Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/

Donate: https://emergencymedicalminute.org/donate/

Avsnitt(1148)

Episode 954: Combo Rescue Inhalers - New Guidelines

Episode 954: Combo Rescue Inhalers - New Guidelines

Contributor: Aaron Lessen, MD Educational Pearls: What is a Rescue Inhaler? A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack.  Historical...

30 Apr 20253min

Episode 953: Penicillin Allergies

Episode 953: Penicillin Allergies

Contributor: Geoff Hogan MD Educational Pearls: Penicillin allergies are relatively uncommon despite their frequent reports 10% of the population reports a penicillin allergy but only 5% of these...

21 Apr 20252min

Episode 952: Heart Transplants

Episode 952: Heart Transplants

Contributor: Travis Barlock, MD Educational Pearls: Key clinical considerations when managing heart transplant patients due to their unique pathophysiology 1. Arrhythmias A transplanted heart i...

14 Apr 20253min

Episode 951: Pediatric Febrile Seizures

Episode 951: Pediatric Febrile Seizures

Contributor: Taylor Lynch, MD Educational Pearls: Pediatric febrile seizures are defined as seizures that occur between the ages of six months to five years in the presence of a fever greater than o...

7 Apr 20256min

Episode 950: Ultrasound Pulse Check During Cardiac Arrest

Episode 950: Ultrasound Pulse Check During Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Point-of-care ultrasound (POCUS) is used to assess cardiac activity during cardiac arrest and can identify potential reversible causes such as peric...

31 Mars 20252min

Episode 949: Hoover's Sign

Episode 949: Hoover's Sign

Contributor: Travis Barlock, MD Educational Pearls: What is Hoover's sign used to identify? This physical exam maneuver differentiates between organic vs. functional (previously known as psychogenic...

24 Mars 20251min

Episode 948: CYP Inducers and Inhibitors

Episode 948: CYP Inducers and Inhibitors

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: CYP enzymes are responsible for the metabolism of many medications, drugs, and other substances CYP3A4 is responsible for the majorit...

17 Mars 20253min

Episode 947: Hypercapnia

Episode 947: Hypercapnia

Educational Pearls: Physiologic stimulation of ventilation occurs through changes in levels of: Arterial carbon dioxide (PaCO2) Arterial oxygen (PaO2) Hypercapnia is an elevated level of CO2...

10 Mars 20253min

Populärt inom Vetenskap

dumma-manniskor
svd-nyhetsartiklar
p3-dystopia
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
rss-ufo-bortom-rimligt-tvivel
rss-vetenskapsradion-2
det-morka-psyket
rss-vetenskapsradion
medicinvetarna
bildningspodden
sexet
rss-geopodden-2
vetenskapsradion
rss-experimentet
4health-med-anna-sparre
halsorevolutionen
rss-spraket
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
hacka-livet