How to deal with post-rash care in young children?

\”Call Daotao G. The baby has had a high fever for 3 days. The fever finally subsided today, but he has a red rash all over his body. What disease is this?\” Today, Daotao G invited a good friend: Zhu Wei, the attending pediatrician at the Second People\’s Hospital of Guangdong Province. Let me share with you [Children’s emergency rash that most babies can’t escape! 】. welcome! 01 Those babies are susceptible to infantile rash. Infantile rash, also called infantile roseola, is the most common acute rash disease in infants and young children. It is mainly caused by human herpes virus type 6. It usually occurs in infants and young children under two years old, and is most common in babies between 6 months and 18 months old. It can occur throughout the year, but is more common in winter and spring. The first high fever in babies after 6 months of age is often caused by acute rash in young children. During the most difficult days of acute rash in young children, there is a sudden high fever, with the body temperature reaching 39.5°C to 40°C, or even higher, which persists or fluctuates. During the period of rising body temperature, a few infants experience febrile convulsions, which may be accompanied by runny nose and light cough. , nausea, vomiting, increased stool frequency and other symptoms, but most of the symptoms are not serious. Generally, high fever suddenly drops to normal when it lasts for 3-4 days, and a rash appears when the fever subsides or a few hours to 1-2 days after the fever subsides. The rash is a rose-red maculopapular rash ranging from 2 to 5 mm in diameter, which fades when pressed. The rash is mainly distributed on the chest, abdomen, back, buttocks, head, face, and neck. Some rashes can merge into sheets. The rash disappears in about 1-2 days without leaving any scars, and the entire course of the disease takes 8-10 days. The fever has subsided and the rash has appeared, which means recovery will be quick. But when I first saw the doctor, the doctor said it was a cold? Even doctors usually diagnose the disease only after the fever subsides and the rash develops. It turns out to be an acute rash in young children. Therefore, many people say that the diagnosis of acute rash in young children is an \”afterthought\”, which is also a limitation of current medicine. If your baby has runny nose, cough, nausea, vomiting, diarrhea, high fever, etc., the doctor may prescribe some oral medications to relieve the current symptoms. This is medically known as symptomatic treatment. However, if the baby\’s symptoms are not too severe, you can use as little medication as possible, especially if you don\’t need antibiotics, and try not to infuse intravenous fluids. Usually doctors will tell parents to give appropriate antipyretic drugs during high fever. At the same time, pay attention to the baby and pay attention to whether there is any occurrence of febrile convulsions. Tips: If a febrile convulsion occurs, here is what you should do: If a child has a convulsion, parents should not panic first! ● Place the child on the bed, lie flat, with the head turned to one side or lying on the side. This will help the vomitus flow out smoothly and will not flow back into the trachea and cause suffocation. ● Do not put anything into the child\’s mouth (convulsions will not bite the tongue), do not restrain and press the child; do not pinch people, etc.; ● Most children with convulsions will stop on their own within 2-3 minutes. After treatment, inform your pediatrician. If it doesn\’t stop after 3-5 minutes, or if it happens several times, or if you have difficulty breathing, suffocation or other serious conditions, you should call 120 immediately. 02 All the nursing questions you want to ask are here. Fever is the body’s physiological resistance process to pathogenic bacteria. It can stimulate certain defense mechanisms of the body and is an active behavior of the body to fight infection. However, fever can also cause children toFeeling uncomfortable, it increases the child\’s need for fluids and increases heart and respiratory rates, and some may be accompanied by symptoms such as shivering and cold extremities. Generally, we recommend that children whose body temperature exceeds 38.5°C should be given antipyretic drugs. It is no longer recommended to use mercury thermometers for thermometers (the main reason is that mercury thermometers are easily broken and unsafe). Digital electronic thermometers (which are safer, can be used correctly, and can obtain accurate body temperature values) are a better choice. Antipyretic drugs ● Acetaminophen (common drug: Tylenol) The 2016 new version of children’s fever guidelines points out that children over 2 months old have a rectal temperature ≥39°C (oral temperature 38.5°C, axillary temperature 38.2), or due to fever For children with fever who are uncomfortable and depressed, acetaminophen can be used to reduce fever. The minimum time interval between two doses is 6 hours. ● Ibuprofen (common drug: Motrin) Children over 6 months old can choose ibuprofen or acetaminophen. The minimum interval between two doses is 6-8 hours. Ibuprofen and acetaminophen have similar antipyretic effects and safety profiles. The commonly used dosage forms for infants and young children are oral drops or suspensions. The dosage of the drug should be calculated based on the child\’s weight on the drug instructions or taken as directed by the doctor. (The dosage calculated based on age is for convenience only. The dosage of antipyretic drugs should be calculated based on the child\’s weight.) Generally, try to choose one antipyretic drug. Taking acetaminophen and ibuprofen at the same time by yourself is not recommended, nor is it recommended Alternate use of acetaminophen and ibuprofen on your own. Although the combined or alternate use of acetaminophen and ibuprofen is more effective in lowering body temperature than either drug alone, it can easily lead to parents giving the wrong drug. Therefore, it is not recommended that parents give their babies a combination of medications themselves. (However, for severe persistent high fever, if there is still a clinical need for cooling, whether combined medication is needed must be taken under the guidance of a doctor, and medication cannot be taken by oneself.) Vomiting after taking medicine. If the baby vomits after taking the medicine within a short period of time, and the vomitus If the baby even vomits out the food, then you need to comfort the baby and then refeed the baby with the full amount of medicine that should be taken this time. If you vomit 30 minutes after taking the medicine, or the amount of vomiting is very small, you do not need to supplement the medicine temporarily. Pay attention to monitoring the body temperature to observe the antipyretic effect. The latest perspective on physical cooling ● Comforting your baby During a fever period, the key to taking care of your baby is to make your baby feel comfortable. Keep your child\’s environment cool and comfortable. When the weather is hot, you can turn on the air conditioner to adjust the indoor temperature. ● Supplementing fluids for fever will increase the body’s consumption and need for water. To ensure adequate fluid intake, children under 6 months old should be fed more milk. Children over 6 months old are recommended to drink more water. ● The diet should be light and easy to digest. Try to choose foods that your baby is used to eating. Do not add new complementary foods during the illness. ● Wear appropriate amounts of clothing if you are not covering your sweat. Do not wear too many thick clothes for your child. It is not recommended to cover your baby with too many clothes or quilts because it is hot. On the one hand, it is not conducive to heat dissipation, or even if the body temperature drops after sweating a lot, But dehydration or electrolyte imbalance caused by excessive sweating will not help recovery. ● The latest 2016 fever guide for warm water baths is no longer recommended.Recommended – the physical cooling method of warm water bath, because the new point of view is that on the basis of using antipyretic drugs, combined with warm water sponge bath, the effect of reducing fever in a short period of time is better, but it will increase the discomfort of children, such as crying, chills, skin Goosebumps. It is not recommended to take bath with ice water (ice pillow, ice cubes). In practical applications, most clinicians now believe that warm water bathing can still be performed if the baby is not very resistant and does not show severe crying or shivering. This will still help lower the body temperature. (Taotao G: In short, if the baby is willing to take a warm bath, we will use it; if the baby resists and feels uncomfortable, we will not use it. The principle of care is that everything is based on the baby’s comfort.) ● Refuse to use alcohol scrubbing bath to cool down because the baby’s skin It is very thin, relatively tender, and has a relatively large body surface area. If you use alcohol to bathe it, the surface of the skin will easily absorb the alcohol and enter the body for metabolism, which will cause more or less damage to the child\’s liver and kidneys. Dr. Zhu\’s hospital has treated babies with alcohol poisoning due to the use of large amounts of alcohol for bathing, so it is best to avoid using alcohol. ● Antipyretic Patch Fever Guide has never recommended antipyretic patch as a treatment method for reducing fever, but it is very popular in China and can be used as a placebo for parents. If the baby does not resist, you can use it, but if the baby is unwilling to use the patch, parents do not have to force it, because the antipyretic effect of the antipyretic patch is really limited. Try not to listen to folk remedies and home remedies that have no medical evidence, so as not to cause inappropriate treatment to bring extra burden to the child. Is acute rash in young children contagious? Urgent rash in young children generally subsides in 1-2 days after the rash appears, and most of the time it does not exceed 3 days. No medication is required during the rash, and it will subside on its own. Urgent rash in young children is a viral infection that can be transmitted through the respiratory tract, but it is not highly contagious. During the period of high fever and rash, children should try to avoid contact with other infants and young children. The conservative view is that there is generally no risk of infection about 3 days after the rash appears. . Can the wind blow? Some elderly people think that rash diseases cannot be exposed to the wind. However, if a baby with an acute rash is taken outdoors, it will not have any impact. They can go out and be exposed to the wind, but if the temperature is too low or When the wind is too strong, you need to take protective measures or go out less often to avoid catching a cold. In addition, you should not go to densely populated areas. Can I take a bath? As long as the baby is willing and in good spirits, he can take a bath. If you have never had infantile rash, is it possible that your immune system is not normal? Relax, there is no need to worry. Although a large number of babies will suffer from infantile rash, not every baby will get it. Urgent rash in young children is a viral infection. Whether or not you have had this disease has no special significance. 03 Don’t just look at a red rash and call it an emergency rash in young children. 1. Hand, foot and mouth disease is highly contagious and can easily cause outbreaks or epidemics, and enterovirus 71 infection causes a larger proportion of severe cases. It may be accompanied by fever or without fever. The rash is mainly located on the hands, feet, buttocks, and oral mucosa. It may be accompanied by mouth pain, sore throat, and refusal to eat. Most cases have a good prognosis. Severe hand, foot and mouth disease can be complicated by meningitis, encephalitis, and pulmonary edema, and severe cases can lead to death. If you want to know more about hand, foot and mouth, you can go to the public account and reply with the keyword hand, foot and mouth 2. Chickenpox is caused by the varicella-zoster virus.The rash appears on the 1st to 6th day of the fever. The rash is centripetally distributed. The rash is dense on the head, face, chest, back and abdomen. The rash is sparse on the limbs, and less on the palms and soles. The rash appears rapidly in batches and develops into blisters over several hours. 1-2 days after the rash appears, the herpes dries and scabs, and the skin peels off after a few days, generally leaving no scars. Some patients experience itching. Systemic symptoms are mostly mild, and possible complications include secondary infection of skin blisters, pneumonia, encephalitis, and myocarditis. 3. Measles is an acute respiratory infectious disease caused by the measles virus. It mainly manifests as fever, rash, conjunctival congestion, photophobia, tearing, sneezing, coughing, etc. Generally, rash appears 3-5 days after fever. When the rash increases, systemic poisoning symptoms worsen, and the body temperature can reach as high as 40°C. Abdominal pain, diarrhea, vomiting, lymph node and hepatosplenomegaly may occur during the course of the disease. Common complications include pneumonia, laryngitis, encephalitis, myocarditis, etc.