CURRENT PATIENTS

Monday, April 8, 2024

We will be CLOSED in the AFTERNOON this day!

Monday, April 8, 2024: Limited staff and hours - call ASAP to schedule - phones OPEN at 7am! 

General Holiday Hours 2024

Business day immediately preceding Holiday day: Limited staff and hours - call ASAP to schedule - phones OPEN at 7am!

Holiday DAY - CLOSED

Business day immediately following Holiday day: Limited staff and hours - call ASAP to schedule - phones OPEN at 7am! 

These details will be updated closer to each holiday. Carine Pediatrics current observes the following holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day.

Fever FAQs

When your kids are sick, it breaks your heart. When they have fever, they can feel tired, grouchy, exhibit fast breathing, or appetite changes. Here are some guidelines for what to do when your child has a fever.

When to go to the ER:

·         For infants less than 2 months of age that have a rectal temperature of 100.4°F. (Yes, rectal measurement. If you do not own a rectal thermometer, it is best to go to the pharmacy and get one for this age.)

·         When fevers persist over 102°F one hour after doses of appropriate fever reducers (see dosing below).

·         If your child is breathing fast, in distress, or having a lot of pain and these symptoms do not reduce with fever reducers. (Try treating the fever first and allowing 30-60 minutes for the fever reducer to work.)

·         If your child is lethargic, won't awaken easily, or is refusing to drink liquids, and this does not correct with fever reducers.

·         If your child has a fever and you are worried about dehydration because your child has not been taking fluids or having adequate urine output (3 urinations in a 24-hour period).

·         Fevers associated with rashes that are purple in nature or are associated with other significant symptoms listed above, should go to the ER.

When to make an office appointment by calling the office:

·         Any time you are worried and want us to check out your child. In the visit, we can answer questions and walk you through options to manage your child's illness.

·         Fevers at the beginning of illness typically represents your body's appropriate, strong response to fight infection. Fevers that START or worsen more than 3-4 days into illness, raise more of a concern for us as medical providers. This need to be evaluated in the office; call us to schedule a visit.

·         Fevers that last 4 days or longer without a known reason in children 2 years of age and older. In infants 2- 6 months we want to see them for any fever over 100.4°F that lasts longer than 2 days, and in children 6 month-2 years, we want to see them for prolonged fever lasting longer than 3-4 days (over 100.4°F).

·         Fevers accompanied with ear pain, sinus pressure, heavy coughing, and/or poor appetite that last longer than 1-2 days.

·         Fevers associated with joint pain that doesn’t resolve with fever reducers.

·         Fevers accompanied by rashes should be seen in the office unless they meet the criteria for ER (detailed above).

When to call the on-call provider:

·         Remember our providers are taking emergency calls from home with their families, or they are asleep. If you are worried about fever in your child, before you call the provider, give your child a dose of fever reducer (in children over 2 months old) to see if they are more comfortable, wait 30-60 minutes after administering the medication before calling a provider or going to the ER.  

·         If your child's symptoms are different from those outlined above (please review them) and you are unsure if you should go to the ER, call to discuss with a provider. 

·         If you feel your child is safe to wait until morning, they are also safe to wait to talk to a provider.

When and how to give fever reducers:

·         If your child has a fever and you are worried or concerned enough to consider calling a provider, or seeking ER care, first give them a dose of fever reducer to see if the child is more comfortable.

·         Fever can be a healthy way of fighting germs. We expect children to be fatigued, grouchy, and have a poor appetite when they have fevers. As long as they are drinking liquids well and breathing comfortably, you do not necessarily need to administer a fever reducer for all elevated temperatures.

·         Physician dosing of fever reducers is done by weight, not age. Below are our guidelines for children 20 pounds and smaller.

·         We discourage Tylenol (acetaminophen) use in children over 6 months of age eligible for ibuprofen (Motrin/Advil).   

Dosing instructions:

Liquid acetaminophen (Infants’ or Children’s) is provided as 160mg/5ml and is dosed every 4 hours.

Babies 2-6 months old:  

10 pounds      80mg or 2.5ml every 4 hours

15 pounds      120mg or 3.5ml every 4 hours

20 pounds      160mg or 5ml every 4 hours

Liquid ibuprofen comes in two concentrations, it is important to read the bottle. Infants’ 50mg/1.25ml, or Children’s 100mg/5ml. (Notice these are very different concentrations.) Ibuprofen is dosed every 6 hours.

Babies/Children Over 6 months:

10 pounds      50mg or 1.25ml Infants’ / 2.5ml of Children’s

15 pounds       75mg or 2ml Infants’ / 3.5ml of Children’s

20 pounds      100mg or 2.5ml Infants’ / 5ml of Children’s

Other notes about dosing:

·         What about alternating acetaminophen and ibuprofen? We do not recommend this practice.

·         Each medicine should be dosed according to the timing of that medication. So, for ibuprofen that is every 6 hours, for acetaminophen that is every 4 hours.

·         There is actually some disadvantage in fever control to give acetaminophen (Tylenol) instead of the superior fever reducer, ibuprofen.

·         If you have instructions by a provider to dose both kinds of fever reducers for a specific reason then follow those instructions, but typically we want our families to use ibuprofen alone over 6 months of age, and acetaminophen alone under 6 months.  

Current Patient Information