Q: My child was diagnosed with the flu and had IV treatment, but their fever is over 40°C and they feel cold. Should we go to the ER?
- Myeongchan Kim
- 1 day ago
- 3 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My elementary school-aged child was diagnosed with the flu today. They received IV treatment and came home, but their fever hasn't dropped below 38°C. Now, the fever has spiked to over 40°C, and fever reducers don't seem to be working. My child keeps saying they are cold and wants to be covered with thick blankets. What should I do? Should I take them to the emergency room at this hour?
Answer:
It is completely understandable to be worried when your child is struggling with such a high fever.
[Check These Red Flags Immediately]
If your child has ANY of the following symptoms, please go to the Emergency Room (ER) right away:
• Difficulty breathing (gasping, chest retractions, or bluish lips)
• Difficulty waking up or unable to make eye contact
• No urination for more than 8 hours
• Stiff neck or severe headache accompanied by repeated vomiting
• Seizures or convulsions
If these symptoms are not present, your child is awake, and they can drink even small amounts of water, you can manage the situation at home by following these steps.
[What to Do at Home Right Now]
1️⃣ Check Fever Reducers (Antipyretics)
• Acetaminophen (e.g., Tylenol): 10–15 mg/kg every 4–6 hours.
• Ibuprofen (e.g., Motrin, Advil): 5–10 mg/kg every 6–8 hours (for infants 6 months and older).
• Check the time and dosage of the last medication given to ensure enough time has passed.
• Alternating between the two medications is generally not recommended as a first step, but if the fever persists with one, you may consider it after consulting a doctor.
2️⃣ Manage Clothing and Blankets
• Even if your child complains of feeling cold, dress them in a single layer of light clothing and use only a light blanket.
• Keep the room temperature comfortable, ideally around 20–24°C (68–75°F).
• ❌ STRICTLY AVOID: Using wet towels, lukewarm baths, or rubbing alcohol to cool the child down.
3️⃣ Keep Them Hydrated
• Offer a sip or two of water or an electrolyte drink every 5–10 minutes.
• Do not force them to drink, but encourage fluids frequently.
[Why the Fever Persists After Flu IV Treatment]
The IV medication your child received today (antiviral drugs like Peramivir) works by inhibiting the replication of the flu virus, but it does not make the fever disappear instantly. It typically takes 24 to 48 hours for the symptoms to start improving, so it is normal to wait and observe their condition until tomorrow afternoon.
[What to Monitor Until Morning]
✅ Check if the fever drops even slightly within 1–2 hours after giving a fever reducer.
✅ Monitor if they are drinking fluids and urinating.
✅ Ensure they can make eye contact and respond when you wake them.
Visit your pediatrician or an urgent care clinic first thing in the morning if ANY of the following occur:
• The fever does not drop at all despite medication, or stays persistently at or above 40°C.
• The child refuses to drink fluids or hasn't urinated for over 8 hours.
• They become increasingly lethargic or excessively irritable.
• New symptoms appear, such as a rash, vomiting, or changes in breathing.
For tonight, focus on managing the medication intervals, keeping their clothing light, and ensuring frequent hydration. Reassess your child's condition in the morning and seek an in-person medical evaluation if symptoms persist or worsen.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
