Amanda Wilde (Host): Coughs and fevers are quite common in childhood, and today our expert speaks to all you need to know about these and other common pediatric symptoms. You'll get tools to assess your child's condition, suggestions for effective home remedies, and clear guidelines on when it's necessary to visit the emergency room.

Registered Nurse Tori Duskey will also answer common pediatric questions from parents next. This is Memorial Health Radio with Memorial Health System Ohio. I'm Amanda Wilde and Tori, it is so good to have you here.

Tori Duskey, RN: Thank you.

Host: Now, especially when you're a new parent, every little sniffle is concerning. So, do we need to take our child to the ER every time they have a cough, runny nose, congestion, or fever?

Tori Duskey, RN: It is not necessary to run to the ER or even the pediatrician every time that your child is sick. There are things that you can do at home to make them feel better and, as long as they are not having any issues breathing or anything, those are completely safe and we do encourage that.

Host: Okay, and we'll talk about some of those things we can do to make our kids feel better. But, when do we need to take our children to the ER for those kind of symptoms, cough, fever, runny nose, those common symptoms?

Tori Duskey, RN: Any time that your child is having difficulty breathing, retractions, which is where they are pulling in, like around their ribs or their collarbones or their neck. We need to see them for that. If they're wheezing, if they have blue lips, if they are truly lethargic and by lethargic, I mean you can't keep your child awake, you cannot wake them up, not just that they are more sleepy than normal. If they don't have any urine output for eight plus hours, and that is, just absolutely no urine output. Not that they've peed a little, it's absolutely none. We need to see them at that point because they are dehydrated. And then if a fever continues past 4 to 5 days, we do recommend that you call the pediatrician to get evaluated.

Host: So those all seem like pretty obvious severe symptoms. With just your basic runny nose, cough, congestion, fever; what can we do at home to make our kids feel better?

Tori Duskey, RN: Yeah, so lots of fluids. We really like popsicles in the pediatric ER. Almost every patient gets a popsicle before they leave, whether they're here for a cold or a stubbed toe, they get a popsicle. You can do a humidifier in their bedroom at night. You can give honey for patients over one year old. Patients under a year old cannot have honey for a cough.

And then, kids that don't want to drink because when kids are sick, they don't want to eat or drink a lot of times, we do suggest, trying a syringe and syringing some fluid into their mouth every little bit. And we say Pedialyte or something with a little bit of sugar rather than water.

Host: Oh, okay. Now speaking of Pedialyte, I'm thinking of the over-the-counter medications like Tylenol and Motrin. How do we know when to give those? And also, dosages. How much to give? Do we give what's on the box?

Tori Duskey, RN: So yes, you can give what is on the box. It's kind of a broad range, so we have a calculation that we use and for Tylenol we give 15 milligrams per kilogram of body weight. And then for Motrin, we give 10 milligrams per kilogram of body weight. We always use kilograms in pediatrics, never pounds.

We are always willing to answer a phone call and tell a parent how much Tylenol or Motrin they should give over the phone because I know that that is kind of a hang up for parents. They don't know how much to give, they under dose their kids, and then they worry because the fever doesn't come down.

So we're always, willing to take a phone call and tell them how much to give if they don't know.

Host: Oh, so that's great, you can get that support and help in the moment when you're unsure. Now Tylenol and Motrin, are those interchangeable terms?

Tori Duskey, RN: They are not. They're two different medications. So we consider a fever anything over 100.4 degrees Fahrenheit. So you can give Tylenol and Motrin in rotation. So you can give Tylenol every six to eight hours and Motrin every six to eight hours, but you can rotate those. So you can give Tylenol and then three to four hours later, give Motrin.

And three to four hours after that, give Tylenol again. That way, the child always has medication on board and their fever doesn't really have a chance to come back.

Host: Now, to dig a little further into that, there's infant Tylenol and infant Motrin, and then there's children's Tylenol and Motrin. Are those the same?

Tori Duskey, RN: Yes, so that is very confusing for patients. Infant Tylenol and children's Tylenol are the exact same concentration. Typically the infant's Tylenol comes with a syringe while the children's Tylenol comes with a cup. So those can be interchangeable. Infant Ibuprofen and children's Ibuprofen are not the same.

So you have to check the dosages and the concentration on the bottle. The infant ibuprofen is twice as concentrated as children's ibuprofen.

Host: Now, we said Tylenol and Motrin can be alternated. Is that true with ibuprofen too, or do you give that for different symptoms?

Tori Duskey, RN: So ibuprofen and Motrin are the same medication. And then Tylenol and acetaminophen are the same medication. It's just brand name versus generic name.

Host: Ah, okay. Thanks for clarifying that. I guess my last question is any warning signs that should prompt immediate medical attention, and also just signs you might look for as something is beginning, so you may be able to treat it before it grows into something more.

Tori Duskey, RN: Times when you should definitely take your child to the ER, any child under 60 days, so about 2 months old, if they have a rectal temperature greater than 100.4 degrees Fahrenheit, they need to be seen in the emergency department because they don't have the immune system to fight off viruses and infections like older children do.

Beyond that, you kind of go back to do they have difficulty breathing, those retractions, wheezing, blue lips, if they're lethargic, or if they don't have any urine output. Those are all things that you need to be seen pretty quickly for.

Host: So those are those really should be obvious symptoms I would think.

Tori Duskey, RN: Yes.

Host: Now let's talk about that other side of the coin when your kid just seems a little sniffly and you don't know what it's gonna develop into. What can you do at that point to sort of head things off?

Tori Duskey, RN: So, I really like the Nosefrida or the Bulbsuction. Suction that snot out of there. That'll make them a whole lot more comfortable. Do the humidifier, lots of fluids. Kids love popsicles, so typically even if they're not willing to eat or drink, they will eat a popsicle. And then just make them comfortable.

And we even say, you don't necessarily need to treat the fever if they don't have symptoms. Treat the child, not the fever. So if they are 100.8, but they are acting completely normal, they're still eating and drinking, they're playing, dancing, you don't necessarily have to treat that. Treat the child.

Host: Okay. And we should note children's fevers run higher than adult fevers.

Tori Duskey, RN: Yes. And then, also, febrile seizures. I know a lot of parents are terrified that their kids are going to have a febrile seizure, and they are very scary. They think that when their child's fever gets to a certain point, they're going to have a seizure, but that's not necessarily true. Febrile seizures happen due to how fast the temperature rises rather than how high it is.

So if they go from 98.6 to 103 in a half hour, that's when you're most at risk for those febrile seizures.

Host: Well, Tori, this information is really helpful to parents to feel more confident in caring for their little ones during illness. Thank you so much.

Tori Duskey, RN: Yeah, thank you for having me.

Host: That was Registered Nurse Tori Duskey. And that wraps up this episode of Memorial Health Radio with Memorial Health System.

Head on over to our website at mhsystem.org/pediatrics for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all other Memorial Health System podcasts. This is Memorial Health Radio with Memorial Health System.