From the Guidelines
A temperature of 103.9 degrees Fahrenheit is considered hyperthermia in a 2-year-old child and requires immediate medical attention. According to the clinical policy for well-appearing infants and children younger than 2 years of age presenting to the emergency department with fever 1, a rectal temperature of greater than or equal to 38.0 C (100.4 F) is generally considered a fever. However, in the context of a 2-year-old child, a temperature of 103.9°F is significantly elevated and may indicate a serious infection.
Key considerations in managing a febrile child include:
- Determining the accuracy of the temperature measurement
- Assessing for signs of serious infection, such as bacteremia or bacterial meningitis
- Evaluating the child's overall appearance and behavior
- Considering the child's immunization status and ability to monitor their condition at home
In terms of management, it is essential to:
- Contact the child's doctor or seek medical care promptly
- Provide fever-reducing medication, such as children's acetaminophen (Tylenol) or children's ibuprofen (Motrin, Advil), as directed by a healthcare professional
- Maintain hydration with frequent small sips of water or an electrolyte solution
- Dress the child in light clothing and maintain a comfortable room temperature
- Monitor for warning signs, such as difficulty breathing, unusual drowsiness, rash, stiff neck, persistent vomiting, or dehydration, which would require immediate emergency care 1.
From the Research
Definition of Hyperthermia
Hyperthermia is generally defined as a body temperature that is higher than normal. In children, a temperature above 100.4°F (38°C) is considered a fever, and temperatures above 103°F (39.4°C) can be considered high fever or hyperthermia [ 2 ].
Temperature Thresholds for Hyperthermia in Children
While the exact temperature threshold for hyperthermia can vary depending on the source and the age of the child, a temperature of 103.9°F (39.9°C) in a 2-year-old child would likely be considered hyperthermia.
Studies on Fever and Hyperthermia in Children
Several studies have investigated the treatment of fever and hyperthermia in children, including the use of antipyretic medications such as ibuprofen and acetaminophen [ 3, 2,4,5,6 ]. However, these studies do not provide a clear definition of hyperthermia in children or a specific temperature threshold for hyperthermia in 2-year-old children.
Key Points
- Hyperthermia is generally defined as a body temperature higher than normal.
- A temperature above 100.4°F (38°C) is considered a fever in children.
- Temperatures above 103°F (39.4°C) can be considered high fever or hyperthermia.
- A temperature of 103.9°F (39.9°C) in a 2-year-old child would likely be considered hyperthermia.
- Antipyretic medications such as ibuprofen and acetaminophen can be used to treat fever and hyperthermia in children [ 3, 2,4,5,6 ].
Some key findings from the studies include:
- Ibuprofen and acetaminophen are effective antipyretic agents in children with a history of febrile seizures 4.
- Ibuprofen yielded significantly greater fever reduction than did acetaminophen 4 hours after the first dose 4.
- Acetaminophen is a safe antipyretic against febrile seizures and has the potential to prevent febrile seizure recurrence during the same fever episode 5.