RICKS FEVER CHART
FEVER IN CHILDREN

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Welcome to the Ricks Fever Chart Supplemental Information Site!
You have the most recent version of Ricks Fever Chart if you have:
RICKS FEVER CHART (first edition) ISBN 0-9710183-0-8

ALL RESPONSIBLE PARENTS SHOULD HAVE A THERMOMETER, ACETAMINOPHEN, AND IBUPROFEN IN THE HOME FOR THE CARE OF THEIR CHILDREN WITH FEVER. GET THE RICKS FEVER CHART TO HELP YOU IN THE CARE OF YOUR CHILD WITH FEVER.

The RICKS FEVER CHART is a 4 page laminated chart containing information on fever in children and the treatment of fever in children. This chart explains:

1. The meaning of fever.
2. The danger of high fever.
3. Febrile seizures.
4. Things to do and things not to do.
5. How heat is loss from the body.
6. Drugs that can cause a fever.
7. The sponge bath for fever.
8. When to contact the doctor.
9. Scientific recommendations.
10. Acetaminophen and Ibuprofen dosage charts.
11. Weight conversions chart.
12. Temperature conversion chart.
13. Excellent Fever Record to document the child's treatment.

The "Fever In Children" chart is temporarily unavailable, but it will again be available for ordering at www.316art.com in the near future.

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CORRECTIONS TO "FIRST EDITION"
1. Ibuprofen Dosage Chart
Some first edition charts have a white line which separates the dosage listing for tablets 100mg from dosage listing for Drops 50mg/1.25ml (dropper). This should be a black line to separate the dosages more clearly. However, it should be obvious which dose applies to which formulation as one is listed as tablets and the other is listed as droppers.
2. Temperature Conversions
The temperature conversion chart has the Fahrenheit and Celsius temperature values closer together beginning at 100.0 degrees. This makes it difficult to read. Lines will be added in future printings to resolve this problem.

NOTE: There is no evidence that alternating acetaminophen and ibuprofen or administering both drugs together lowers fever faster or helps children recover more quickly. Some pediatricians express concern that this combination might increase the risk of toxicity, such as kidney damage.

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USING A THERMOMETER

Taking a rectal temperature:
This may not be the best method in children with rectal irritation, diarrhea, or stool present in rectum. There are also digital thermometers for measuring rectal temperature.
1. Use only a rectal thermometer (it has the short stubby round tip).
2. Shake the thermometer down to below 97 F (36 C).
3. Lubricate the silver bulb end of the thermometer with Vaseline, petroleum jelly, or cold water.
4. Hold the child still down on the stomach. It is often helpful to hold the child's stomach down on you lap by applying mild pressure to the child's back.
5. Spread the buttock to see the anal opening.
6. Gently insert the silver bulb end of the thermometer 1/2 inch into the anal opening (rectum).
7. To prevent injury, hold the thermometer firmly between the fingers while also using the palm of the hand on the buttocks to prevent movement of the child.
8. Leave the thermometer in place for 1 to 3 minutes.
9. Do not leave the child unattended.
10. Remove the thermometer.
11. Read the thermometer by turning the thermometer's slightly in each direction until you see the silver mercury column.
12. The temperature is the number at the end of the silver column. The lines between the major degree numbers on the thermometer are 0.2 F on the Fahrenheit thermometer and 0.1 C on the Celsius thermometer.
13. Write the temperature down.
14. When finished, shake the thermometer down below 97 F (36 C), wash the thermometer with soap and cool water, dip it in alcohol, gently wipe it off, and put it up in a safe place.

Taking an oral temperature:
This may not be the best method in children with oral lesions, mouth breathing, seizures, or children unable to cooperate. There are also digital thermometers for measuring oral temperature.
1. Use only an oral thermometer (it has the elongated tip).
2. Shake the thermometer down to below 97 F (36 C).
3. Have the child open the mouth.
4. Place the silver bulb end of the thermometer under the tongue.
5. Have the child close his lips around the thermometer.
6. Instruct the child not to bite the thermometer and not to talk with the thermometer in the mouth.
7. Leave the thermometer in place for 3 minutes.
8. Do not leave the child unattended.
9. Remove the thermometer.
10. Read the thermometer by turning the thermometer's slightly in each direction until you see the silver mercury column.
11. The temperature is the number at the end of the silver column. The lines between the major degree numbers on the thermometer are 0.2 F on the Fahrenheit thermometer and 0.1 C on the Celsius thermometer.
12. Write the temperature down.
13. When finished, shake the thermometer down below 97 F (36 C), wash the thermometer with soap and cool water, dip it in alcohol, gently wipe it off, and put it up in a safe place.

Taking a tympanic (ear) temperature:
This may not be the best method in children with small ear canals, children with ear canals occluded by wax, children with ear infections, or children with sinusitis. Follow the directions included with the tympanic temperature-measuring device. General Instructions:
1. Make sure the lens is clean, dry, undamaged, and free of debris before use.
2. Center the probe tip in the ear and point it toward the eardrum (tympanic membrane)
3. Firmly seal the ear canal opening to eliminate the effect of ambient air.
4. Hold the head if necessary to prevent movement.
5. The temperature can be taken with this device if the child is awake or asleep.
6. If the temperature is unusually low or high:
---(a.) Take the temperature again with the tympanic thermometer.
---(b.) Recheck the temperature with a rectal thermometer
---(c.) Clean the thermometer lens with dry tissue or a swab.
---(d.) Make sure the probe tip is not cracked or chipped.
---(e.) Have the thermometer checked by a trained technician.
NOTE: Proper technique must be used. The sensor must detect heat from the eardrum and not the cooler ear canal. Therefore the probe must be pointed at the eardrum. The ear canal must be straightened. In children under 3 years of age, the ear lobe must be pulled down and back. In children over 3 years of age, the ear lobe must be pulled up and back. The probe is then pointed in the ear to the midpoint between the opposite side's eyebrow and sideburn. The most common reasons for a low tympanic thermometer reading is a dirty lens (the lens can have fingerprints, earwax, or residue on it), followed by improper technique in the use of the thermometer.

HOW TO USE THE FEVER RECORD PAGE (FOUND ON THE RICKS FEVER CHART):
The child with fever record is very useful for documenting the important symptoms and history of the child's illness. Keeping this record will be very helpful not only to the parent, but also to the physician when or if the child is seen by a physician.

• First, Save the original chart. Make a copy of the original chart and complete the copy when documenting on the child with fever. (Alternatively, write on the laminated surface with a marker made for writing on laminated surfaces. You can then erase the markings later using products recommended by the marker manufacturer. Usually rubbing alcohol will erase the markings without difficulty. You may want to try this on some unwanted laminated material prior to use of the fever chart). BE CAREFUL! PERMANENT MARKERS CANNOT BE ERASED FROM THE CHART'S SURFACE.
• Fill in the child's name, date of birth, allergies, SS# (social security number), and age.
• Weigh the child and enter it in the proper space. Be sure to indicate if this weight is in (lb) pounds or (kg) kilograms.
• Look up the acetaminophen and ibuprofen dose recommended for the child. Enter the dose in "mg" and not as "drops" or "suppositories" or "tablets". After finding and entering this dose, you should then determine the number of tablets or drops to be given based on the type of acetaminophen or ibuprofen that you are using. This could be written at the top of the page as a reminder to you. If possible, use weight to find the recommended dose. If you cannot weigh the child, the age on the chart can also be used to find the recommended dose.
• The name of the child's insurance company, insurance policy number, and insurance phone number should also be listed in the appropriate spaces.
• Fill in the names of any medications that the child is taking.
• List the child's past illnesses or surgeries.
• It is important to list the name, address, and phone number (including area code) of the child's parents, physician, and hospital.
• Use a separate line for each time the child is evaluated or given acetaminophen or ibuprofen.
• Enter the date and time, the amount of acetaminophen or ibuprofen given, the child's heart rate, and the child's breathing rate.
• Check the inside of the child's mouth and enter "yes" if it is moist and "no" if it is dry.
• If the child (over 6 weeks of age) is crying, enter "yes" if tears or present and "no" if there are not any tears.
• If the child has chills or shivering, enter "yes". If the child does not have chills or shivering, enter "no".
• The Observation column is used to enter notations that represent the child's symptoms.
  Enter "A" in the column if the child has Abdomen Pain.
  Enter "B" in the column if the child has Achiness.
  Enter "C" in the column if the child has a Cough.
  Enter "D" in the column if the child has Diarrhea.
  Enter "E" in the column if the child has Ear Pain.
  Enter "G" in the column if the child has No Energy.
  Enter "H" in the column if the child has a Headache.
  Enter "I" in the column if the child is Irritable.
  Enter "K" in the column if the child has No Appetite.
  Enter "N" in the column if the child has a Runny Nose.
  Enter "R" in the column if the child has No urine output.
  Enter "S" in the column if the child has a Skin Rash.
  Enter "T" in the column if the child has a Sore Throat.
  Enter "V" in the column if the child is Vomiting.
  Enter "Y" in the column if the child is Sleepy.
  Enter "Z" in the column if the child has a Problem Sleeping.

HOW TO USE SUPPOSITORIES
. (1) Suppositories are designed to melt inside the rectum of the child. Keep them in a cool place to prevent them from melting. If they feel too soft, place them in the refrigerator for 15 minutes before use.
(2) If possible, use mild soap and warm water to clean around the rectum. Rinse thoroughly and dry by patting or blotting with toilet tissue or a soft cloth.
(3) Remember to remove the wrapper before inserting the suppository.
(4) Place the child flat on the back or on the side with anal opening exposed. If possible, the child should be placed on one side with the knees folded up toward the stomach.
(5) Gently insert the pointed end of the suppository by pushing the suppository into the child's rectum. Use the fingertip to completely insert the suppository. Don't force the suppository any farther than it will go easily.
(6) Wash your hands when finished.
(7) Keep the child lying still for about 15 minutes to allow the suppository to melt and be absorbed into the child's body.

BRANDS OF ACETAMINOPHEN
Acephen Suppositories 120mg, 325mg, 650mg
Aceta Elixir 120mg/5ml
Aceta tablets 325mg, 500mg
Acetaminophen Capsules 500mg
Acetaminophen chewable tablets 80mg
Acetaminophen Drops solution 100mg/1ml
Acetaminophen Elixir 120mg/5ml, 160mg/5ml
Acetaminophen Liquid 160mg/5ml, 500mg/15ml
Acetaminophen Supp. 120, 300mg, 325mg, 650mg
Acetaminophen Tablets 325mg, 500mg, 650mg
Apacet chewable tablets 80mg
Apacet solution 100mg/1ml
Arthritis Foundation Aspirin Free Caplets 500mg
Aspirin Free Anacin Max. Strength Gelcaps 500mg
Aspirin Free Anacin Max. Strength Tablets 500mg
Aspirin Free Pain Relief Caplets 500mg
Aspirin Free Pain Relief Tablets 325mg, 500mg
Dapacin capsules 325mg
Dynafed E.X., Extra Strength tablets 500mg
Dynafed Jr, Children's chewable tablets 80mg
Fem-Etts tablets 325mg
Feverall Children's Capsules 80mg
Feverall Children's Sprinkle 80mg
Feverall Children's Suppositories 120mg
Feverall Infants Suppositories 80mg
Feverall Junior Strength Capsules 160mg
Feverall Junior Strength Sprinkle 160mg
Feverall Junior Strength Suppositories 325mg
Genapap Children's chewable tablets 80mg
Genapap Children's Elixir 160mg/5ml
Genapap Extra Strength Caplets 500mg
Genapap Extra Strength tablets 500mg
Genapap Infants' Drops 100mg/1ml
Genapap Tablets 325mg
Genebs Extra Strength Caplets 500mg
Genebs Extra Strength tablets 500mg
Genebs tablets 325mg
Halenol Children's Liquid 160mg/5ml
Liquiprin Drops For Children Solution 80mg/1.66ml
Mapap Children's Elixir 160mg/5ml
Mapap Extra Strength Tablets 500mg
Mapap Infant Drops 100mg/1ml
Mapap Regular Strength Tablets 325mg
Maranox tablets 325mg
Meda Cap Capsules 500mg
Meda Tab Tablets 325mg
Neopap Suppositories 125mg
Oraphen-PD Elixir 120mg/5ml
Panadol Caplets 500mg
Panadol Children's chewable tablets 80mg
Panadol Children's Liquid 160mg/5ml
Panadol Infants' Drops 100mg/1ml
Panadol Junior Strength Caplets 160mg
Panadol Tablets 500mg
Redutemp tablets 500mg
Ridenol Elixir 80mg/5ml
Silapap Children's Elixir 80mg/2.5ml
Silapap Infants solution 100mg/1ml
Tapanol Extra Strength Caplets 500mg
Tapanol Extra Strength Gelcaps 500mg
Tapanol Extra Strength tablets 500mg
Tapanol Regular Strength tablets 325mg
Tempra 1 Solution 100mg/1ml
Tempra 2 syrup Liquid 160mg/5ml
Tempra 3 Chewable tablets 80mg
Tempra tablets 160mg
Tylenol Children's Chewable Tablets 80mg
Tylenol Children's Elixir 80mg/2.5ml
Tylenol Children's Suspension 160mg/5ml
Tylenol Extended Relief Caplets 650mg
Tylenol Extra Strength Gelcaps 500mg
Tylenol Extra Strength Geltabs 500mg
Tylenol Extra Strength Liquid 500mg/15ml
Tylenol Extra Strength tablets 500mg
Tylenol Infants' Concentrated Drops 80mg/0.8ml (160mg/1.6ml=2 dropperfuls)
Tylenol Junior Strength Chewable Tablets 160mg
Tylenol Junior Strength tablets 160mg
Tylenol Regular Strength Caplets 325mg
Tylenol Regular Strength tablets 325mg
Uni-Ace solution 100mg/1ml

BRANDS OF IBUPROFEN
Advil Caplets 200mg
Advil Liqui-Gels Capsules 200mg
Advil Children's Suspension 100mg/5ml
Advil Junior Strength Tablets 100mg
Advil Pediatric Drops 100mg/2.5ml
Advil Tablets 200mg
Arthritis Foundation Tablets 200mg
Bayer Select Pain Relief Formula Caplets 200mg
Dynafed IB Tablets 200mg
Genpril Caplets 200mg
Genpril Tablets 200mg
Haltran Tablets 200mg
Ibuprin Tablets 200mg
Ibuprofen Caplets 200mg
Ibuprofen Tablets 200mg
Menadol Tablets 200mg
Midol IB Tablets 200mg
Motrin Children's Suspension 100mg/5ml
Motrin Children's Tablet 50mg
Motrin Children's Tablets 100mg
Motrin IB Caplets 200mg
Motrin IB Gelcaps 200mg
Motrin IB Tablets 200mg
Motrin Oral Drops 50mg/1.25ml (dropperful)
Motrin Tablets 100mg
Nuprin Caplets 200mg
Nuprin Tablets 200mg
PediaCare Fever Drops 50mg/1.25ml (dropperful)
PediaCare Fever Liquid 100mg/5ml
Saleto-200 Tablets 200mg

BACTERIAL AND VIRAL LLNESSES
(A) Acetaminophen and/or ibuprofen will not cure a cold or the flu (influenza), but they will lower the temperature and make the child feel better.
(B) Acetaminophen and/or ibuprofen will lower temperature and make the child feel better after recent immunizations.
(C) Antibiotics are needed for bacterial infections such as Strep Throat. Acetaminophen and/or ibuprofen will not eliminate the infection.

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Starr Vison Productions, Inc.
Alfred Ricks Jr., M.D.
2142 Riverside Drive
West Columbia, TX 77486.
aricks@healthcallin.com
Please e-mail us if you have further question concerning Ricks Fever Chart.