What medication can be given to a 1 year and 10 month old child with fever and vomiting?

Management of Fever and Vomiting in a 1-Year 10-Month-Old Child

For a 1-year 10-month-old boy with fever and vomiting, appropriate management includes oral rehydration therapy with small, frequent volumes, acetaminophen for fever control, and continued age-appropriate diet once rehydration is achieved. 1

Initial Assessment and Management

• Assess hydration status through physical examination, which is the best way to evaluate a child with vomiting and fever 2
• Look for red flag signs including altered mental status, toxic appearance, severe dehydration, bilious vomiting, or bloody vomiting 3
• Fever should be measured with an accurate thermometer, not just by touch 4

Fluid Management

• For mild to moderate dehydration, oral rehydration therapy (ORT) is the mainstay of treatment and is as effective as intravenous rehydration for preventing hospitalization 2
• Begin oral rehydration with small, frequent volumes (e.g., 5 mL every minute) using a spoon or syringe under close supervision 1
• Gradually increase the amount as tolerated 1
• Replace ongoing fluid losses from vomiting with appropriate volumes of oral rehydration solution 1

Fever Management

• Acetaminophen can be safely administered for fever control 5
• Avoid aspirin in children under 16 years of age due to risk of Reye's syndrome 1
• Non-pharmacological measures should include:
  • Encouraging adequate fluid intake to maintain hydration 6
  • Appropriate light clothing (avoid overwrapping) 6
  • Maintaining comfortable ambient temperature 6
  • Tepid sponging is NOT recommended as it can cause discomfort without lasting benefit 6

Dietary Recommendations

• Once rehydration is achieved, resume age-appropriate diet immediately 1
• For children receiving solid foods, continue their usual diet during the illness 1
• Recommended foods include starches, cereals, yogurt, fruits, and vegetables 1
• Avoid foods high in simple sugars and fats 1

Antiemetic Considerations

• Antiemetics are not routinely recommended for children under 4 years of age 1
• Ondansetron may be considered in older children (>4 years) to facilitate oral rehydration when vomiting is persistent 1

When to Seek Further Medical Care

• Indicators for referral to hospital include:
  • Signs of respiratory distress
  • Cyanosis
  • Severe dehydration
  • Altered consciousness
  • Prolonged vomiting (>24 hours)
  • Drowsiness
  • Signs of septicemia (extreme pallor, hypotension, floppy infant) 1

Important Cautions

• Antimotility drugs (e.g., loperamide) should NOT be given to children under 18 years of age with acute diarrhea 1
• Antibiotics are not routinely indicated unless there are specific indications such as dysentery, high fever with watery diarrhea lasting more than 5 days, or when specific bacterial pathogens are identified 1
• Routine laboratory tests are not necessary for mild illness when viral gastroenteritis is the likely diagnosis 2

Remember that most febrile illnesses in children are self-limiting, but careful assessment and appropriate supportive care are essential to prevent complications 4.