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Hi Doctor, I Need An Urgent Response Please. I Have

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Posted on Sat, 20 Apr 2019
Question: Hi doctor,
i need an urgent response please.
i have a 2 years old child, who had sudden onset of fever today.
the temperature raised to 39.2 and she developed febrile seizure. she had febrile seizure history once before so i knew what to do. i put her on the side
immidiately i administered her 250mg paracetamol suppository.
later i checked her weight and i found out she is only 10kg. and for 250mg suppository she should be 13 to 15kg.
she is now fine and sleeping well, i tried to give her water but she drunk only a little bit. now she is sleeeping

now i'm worried i might have overdosed her.
my questions
1. she is 10kg and i gave her 250mg suppository is that considered overdosage should i take her to emergency now? or is that fine if it's only once.?
2. can i give her paracetamol syrup after 4 to 6 hours if the fever comes back or should i avoid anymore paracetamol since she took 250mg already?

Please answer as soon as you can so i can act on ur suggestion immidiately.
THANK YOU
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Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
Hi doctor,
i need an urgent response please.
i have a 2 years old child, who had sudden onset of fever today.
the temperature raised to 39.2 and she developed febrile seizure. she had febrile seizure history once before so i knew what to do. i put her on the side
immidiately i administered her 250mg paracetamol suppository.
later i checked her weight and i found out she is only 10kg. and for 250mg suppository she should be 13 to 15kg.
she is now fine and sleeping well, i tried to give her water but she drunk only a little bit. now she is sleeeping

now i'm worried i might have overdosed her.
my questions
1. she is 10kg and i gave her 250mg suppository is that considered overdosage should i take her to emergency now? or is that fine if it's only once.?
2. can i give her paracetamol syrup after 4 to 6 hours if the fever comes back or should i avoid anymore paracetamol since she took 250mg already?

Please answer as soon as you can so i can act on ur suggestion immidiately.
THANK YOU
doctor
Answered by Dr. Dr. Antoneta Zotaj (1 hour later)
Brief Answer:
There is nothing to worry, the dose is too small compared to poisoning dose

Detailed Answer:
Hello and welcome to "Ask a Doctor" service.

The dose of paracetamol that your daughter has received is one dose only and is not much more from the dose she would normally get. Normally we recommend 10-15 mg per kg so she could have taken a dose of 150 mg while she took 250 mg which is only 100 mg more.
She got a higher dose than she needed but she is not having overdose so you do not need to worry. If she gets a daily dose of paracetamol of 1500 mg or higher, this would be concerning.

Because you already gave her a little higher dose of paracetamol you may choose to give her ibuprofen 100 mg next if fever goes up, just for your peace of mind but even if you give her paracetamol 100 mg in 4-6 hours I think she is going to be still fine.

To conclude:
She did receive a bit higher dose than she needed but it is not too much and is not going to poisin her
You may give paracetamol 100 mg every 4-6 hours, it will not be a problem. If you are too worried give her ibuprofen 100 mg in the next 4-6 hours and restart paracetamol in 10 hours (6 hours after ibuprofen)

I hope this answers your query.
Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
There is nothing to worry, the dose is too small compared to poisoning dose

Detailed Answer:
Hello and welcome to "Ask a Doctor" service.

The dose of paracetamol that your daughter has received is one dose only and is not much more from the dose she would normally get. Normally we recommend 10-15 mg per kg so she could have taken a dose of 150 mg while she took 250 mg which is only 100 mg more.
She got a higher dose than she needed but she is not having overdose so you do not need to worry. If she gets a daily dose of paracetamol of 1500 mg or higher, this would be concerning.

Because you already gave her a little higher dose of paracetamol you may choose to give her ibuprofen 100 mg next if fever goes up, just for your peace of mind but even if you give her paracetamol 100 mg in 4-6 hours I think she is going to be still fine.

To conclude:
She did receive a bit higher dose than she needed but it is not too much and is not going to poisin her
You may give paracetamol 100 mg every 4-6 hours, it will not be a problem. If you are too worried give her ibuprofen 100 mg in the next 4-6 hours and restart paracetamol in 10 hours (6 hours after ibuprofen)

I hope this answers your query.
Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (2 days later)
Hi doctor, thanks alot for the clear answer.
I have been administering her paracetamol 125mg suppository now and also inter changing it with ibuprofen syrup 2.5ml

So far upto now
the fever started the night before yesterday night of 27th, and it was coming back every 5 hours of the medication since then until yesterday the 29th. The fever almost did not return and we didnt give her any medicine for the whole day but again today morning it came back with 39.1
So she had 1 day and half of fever and 1 day without any fever at all and again fever now.
1.I'm wondering what's the cause of this return and if this is normal with children.

2..does this mean the virus or whatever that's causing the fever remitted again?
3.should this return of fever be more concerning?

By the way she has no any other symptoms, no cough or etc. She is playful and eating well.


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Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
Hi doctor, thanks alot for the clear answer.
I have been administering her paracetamol 125mg suppository now and also inter changing it with ibuprofen syrup 2.5ml

So far upto now
the fever started the night before yesterday night of 27th, and it was coming back every 5 hours of the medication since then until yesterday the 29th. The fever almost did not return and we didnt give her any medicine for the whole day but again today morning it came back with 39.1
So she had 1 day and half of fever and 1 day without any fever at all and again fever now.
1.I'm wondering what's the cause of this return and if this is normal with children.

2..does this mean the virus or whatever that's causing the fever remitted again?
3.should this return of fever be more concerning?

By the way she has no any other symptoms, no cough or etc. She is playful and eating well.


doctor
Answered by Dr. Dr. Antoneta Zotaj (1 hour later)
Brief Answer:
Very likely is the same virus, details below

Detailed Answer:
Hello,

The most important indicator in a child is how the child looks, if she is active and playful and eating well and the fever is there for less than 3-4 days, it is very likely nothing to worry. Just make sure she drinks well, not to get dehydrated.

It may happen that there may be a break in fever and seem it comes back. this may be the same virus (it might take around 5-7 days for it to be cleared from the body) or a new virus (especially if she is in day care). I believe very likely is the same virus that has not cleared yet.

Rarely a complication with tonsillitis or pneumonia van be the cause of fever coming back but in this case she would feel unwell, not be so active and playful.

I would recommend you to continue with the treatment with ibuprofen and paracetamol and if needed baths. It she has fever for 2-3 more days or she is not that active and not eating well or she develops new symptoms she will need to see a doctor.

I hope this answers your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
Very likely is the same virus, details below

Detailed Answer:
Hello,

The most important indicator in a child is how the child looks, if she is active and playful and eating well and the fever is there for less than 3-4 days, it is very likely nothing to worry. Just make sure she drinks well, not to get dehydrated.

It may happen that there may be a break in fever and seem it comes back. this may be the same virus (it might take around 5-7 days for it to be cleared from the body) or a new virus (especially if she is in day care). I believe very likely is the same virus that has not cleared yet.

Rarely a complication with tonsillitis or pneumonia van be the cause of fever coming back but in this case she would feel unwell, not be so active and playful.

I would recommend you to continue with the treatment with ibuprofen and paracetamol and if needed baths. It she has fever for 2-3 more days or she is not that active and not eating well or she develops new symptoms she will need to see a doctor.

I hope this answers your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (1 hour later)
Hi doctor highly appreciate your quick response.
We are actually on tour to Germany in a cold city it started after a long walk in the cold.
Today she is less playful she refused to eat other than 3 biscuits, but she keeps drinking water and juice alot. That's all she asks for.
She is tired today because she was grumpy all last night and hardly slept and kept waking up for water
My son who is 4 years old developed fever today as well, seems like the same virus.
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Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
Hi doctor highly appreciate your quick response.
We are actually on tour to Germany in a cold city it started after a long walk in the cold.
Today she is less playful she refused to eat other than 3 biscuits, but she keeps drinking water and juice alot. That's all she asks for.
She is tired today because she was grumpy all last night and hardly slept and kept waking up for water
My son who is 4 years old developed fever today as well, seems like the same virus.
doctor
Answered by Dr. Dr. Antoneta Zotaj (35 minutes later)
Brief Answer:
Further advices below

Detailed Answer:
Hello,

It is good she is asking for some juice and water so try to offer these often. It might be a good idea to offer fruit in small portions time after time (small pieces of apple, banana or whichever fruit she might want), you may also blend the fruit and offer it as juice.

The fact that her brother has started with fever is a sign that they are both having a viral infection.

At age of two she might be able to complain if she has some discomfort so if she complains of her throat (you can also check her throat for redness and white patches) or burning urine or if she starts with cough it might be best to have her examined by a doctor.



I hope this answers your query. Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj,
General and Family Physician
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
Further advices below

Detailed Answer:
Hello,

It is good she is asking for some juice and water so try to offer these often. It might be a good idea to offer fruit in small portions time after time (small pieces of apple, banana or whichever fruit she might want), you may also blend the fruit and offer it as juice.

The fact that her brother has started with fever is a sign that they are both having a viral infection.

At age of two she might be able to complain if she has some discomfort so if she complains of her throat (you can also check her throat for redness and white patches) or burning urine or if she starts with cough it might be best to have her examined by a doctor.



I hope this answers your query. Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj,
General and Family Physician
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4435 Questions

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Hi Doctor, I Need An Urgent Response Please. I Have

Hi doctor, i need an urgent response please. i have a 2 years old child, who had sudden onset of fever today. the temperature raised to 39.2 and she developed febrile seizure. she had febrile seizure history once before so i knew what to do. i put her on the side immidiately i administered her 250mg paracetamol suppository. later i checked her weight and i found out she is only 10kg. and for 250mg suppository she should be 13 to 15kg. she is now fine and sleeping well, i tried to give her water but she drunk only a little bit. now she is sleeeping now i'm worried i might have overdosed her. my questions 1. she is 10kg and i gave her 250mg suppository is that considered overdosage should i take her to emergency now? or is that fine if it's only once.? 2. can i give her paracetamol syrup after 4 to 6 hours if the fever comes back or should i avoid anymore paracetamol since she took 250mg already? Please answer as soon as you can so i can act on ur suggestion immidiately. THANK YOU