What to do for hyperthermia (elevated body temperature) of 103.5 degrees Fahrenheit?

From the Guidelines

For a temperature of 103.5°F (39.7°C), the most effective treatment is to take acetaminophen (Tylenol) 650-1000mg or ibuprofen (Advil, Motrin) 400-600mg to reduce the fever, as well as apply cool compresses to the forehead, neck, or armpits, and dress in lightweight clothing. This approach is supported by the most recent and highest quality study, which suggests that antipyretic medication can help reduce body temperature and relieve discomfort associated with hyperthermia 1.

Key Considerations

• The patient should stay hydrated by drinking plenty of fluids like water, diluted juice, or sports drinks.
• Rest is essential while the body fights the infection.
• If the fever persists above 103°F for more than 2 days, or if severe symptoms like difficulty breathing, chest pain, confusion, severe headache, stiff neck, persistent vomiting, or seizures occur, seek medical attention immediately.
• For children, contact a doctor sooner - within 24 hours for high fevers.

Rationale

The European Stroke Organisation (ESO) guidelines for the management of temperature in patients with acute ischemic stroke suggest that antipyretic medication can be used to reduce body temperature and relieve discomfort associated with hyperthermia, although the strength of the recommendation is weak 1. Additionally, a study on climatic heat stress and exercising children and adolescents recommends prompt rapid cooling and hydration for individuals with clinical signs or symptoms suggestive of moderate or severe heat stress 1.

Important Notes

• Fever is the body's natural defense mechanism against infection, but very high fevers can be dangerous and may indicate a serious underlying condition requiring medical evaluation.
• The patient's temperature should be monitored closely, and medical attention should be sought if the fever persists or worsens over time.

From the FDA Drug Label

Stop use and ask doctor if • fever gets worse or lasts more than 3 days These could be signs of a serious condition.

The patient's fever is 103.5 degrees Fahrenheit, which is considered hyperthermia.

• The drug label does not provide specific guidance on how to manage a fever of this magnitude.
• However, it does advise to stop use and ask a doctor if the fever gets worse or lasts more than 3 days. Since the label does not directly address the management of hyperthermia at 103.5 degrees Fahrenheit, the best course of action would be to seek medical attention. 2

From the Research

Treatment Options for Hyperthermia

• For a body temperature of 103.5 degrees Fahrenheit, treatment options include the use of antipyretics such as acetaminophen and ibuprofen 3, 4, 5, 6, 7
• The primary goal of treating hyperthermia should be to improve the individual's overall comfort rather than focusing solely on normalizing body temperature 3
• There is no evidence that fever itself worsens the course of an illness or causes long-term neurologic complications 3

Antipyretic Regimens

• Combined paracetamol and ibuprofen therapy may result in a lower mean temperature at one hour after treatment compared to monotherapy alone 4, 6
• Alternating paracetamol and ibuprofen therapy may also be effective in reducing temperatures, with some studies suggesting it may be more effective than monotherapy alone 4, 5, 6
• However, the evidence for improvements in measures of discomfort remains inconclusive, and further research is needed to assess the safety and efficacy of combined and alternating antipyretic therapy 4, 6

Administration and Dosage

• Caregivers are often advised to initially give a single agent (paracetamol or ibuprofen) and then give a further dose of the alternative if the individual's fever fails to resolve or recurs 4, 6
• The method of alternation may vary, and there is currently no standardized approach to alternating antipyretics 7
• Pediatricians should promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices 3