Pharmahealthblog. Health and medical information

At any given moment, different parts of the body are at different temperatures. Moreover, normal temperatures vary as much as one or two degrees Centigrade over the course of a day even when a child is healthy. A rectal temperature of 37.7 °C or less, an oral temperature of 37.7°C or below, and an armpit temperature, though the least accurate, of 36.7°C or less are all considered normal.

Despite these variations, all thermometers are marked to indicate 37°C as normal. A rectal thermometer differs from an oral one only in having a more rugged bulb. (The most practical instrument for home use is a stubby bulb thermometer, which can be used to take a child’s temperature in any of the preferred ways.)

For the most reliable readings at any age, the rectal thermometer is recommended, although it takes a little longer for the temperature to register.

No one can accurately estimate the degree of a fever by touch. If your child feels warm or appears ill, you must use a thermometer to register the accurate temperature that you and your doctor need to know in order to treat the child.

Before using the thermometer, shake it down to be certain the mercury column is below 37°C and the bulb is intact. Then spread the child’s buttocks with the thumb and forefinger of one hand so the anal opening is clearly visible. Lubricate the bulb with petroleum jelly and insert it gently into the center of the anus. The child should feel no pain or discomfort. (Only the bulb portion of the thermometer needs to be inserted for the two to three minutes required to obtain an accurate reading.)

To take a baby’s temperature, place the child face down on a solid surface and put the heel of your hand firmly on the lower back. An unwilling toddler can be firmly clasped between your thighs and bent forward over your leg so that you can take the temperature.

Although less reliable, an oral temperature reading is sufficient and can be taken in a child who is old enough to hold the bulb of the thermometer under the tongue with the mouth closed for three minutes. (If the thermometer breaks and the child accidentally swallows the mercury in the thermometer, don’t fret. Thermometers contain elemental mercury, which is a nonpoisonous and harmless form of the metal.)

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Symptom: A surface skin wound that is longer and wider than it is deep

Home care: Wash the wound with soap and water and look carefully for embedded dirt or any other foreign matter.

Stop bleeding by covering the wound with gauze and applying gentle pressure.

If there’s no dirt in the wound, apply a non-stinging antiseptic, cover the abrasion, and keep it covered until completely healed.

If necessary, scrub gently to remove embedded dirt. Liberally apply antibiotic ointment to help keep the scab flexible. Keep the area covered.

Precautions

-    Do not treat at home any abrasion that involves the full thickness of the skin; take the child to the doctor.

-    If dirt is left in an abrasion, it may cause infection or become sealed under the skin.

-    An abrasion on an area such as a joint that is subject to constant movement should be swabbed periodically with ointment to prevent cracking.

-    An abrasion that bleeds evenly over its entire surface requires medical attention.

-    Keep your child’s tetanus immunization up to date.

An abrasion is a shallow break in the skin caused by an injury. Abrasions are distinguished from cuts and lacerations in that they are not as deep as they are long or wide. Abrasions are, certainly, the most common and least dangerous injuries sustained by children. Most abrasions do not involve the loss of full thickness of skin and heal with little or no scarring. However, any embedded dirt, sand or gravel may be permanently sealed under the skin if it’s not removed before the abrasion heals.

Signs and symptoms

Abrasions are easy to identify. As long as the full thickness of the skin has not been injured, the entire surface of the abrasion will bleed unevenly and some large and small areas will not bleed at all. When the surface of an abrasion does not bleed uniformly, it is classified as a first-or second-degree abrasion and can be treated at home. A third-degree abrasion bleeds uniformly over its entire surface and must be seen by a doctor because it could leave a scar.

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Why do some children having insulin get lumps or swellings at the injection spots?

Repeated injections of insulin at the one spot cause the fat at that spot to swell up and cause a lump. Children who develop lumps or swellings have usually done so because they have got a favourite spot which they use all the time, perhaps because it is less painful after repeated injections at one area. Lumps of this sort can be avoided by moving the injection site from leg to leg and to different places each day. If a lump has developed it will disappear again provided no more injections are put into that area. These swellings are sometimes called ‘insulin tumours’ but they are harmless and are not growths or real tumours.

Is there anything wrong with injecting insulin into the swellings at injection sites? They hurt less.

It is better to avoid injection sites that have become swollen, even if they are less painful. If you keep injecting there, the swelling may get larger and become embarrassing. The longer you inject into a lump, the longer it will stay swollen. Sometimes insulin injected into a swelling is absorbed less well, so that you may get erratic diabetic control.

Repeated injections into a swelling can increase the risk of an infection developing there, though this is unlikely.

Why can’t I take a bit more insulin and have sugary things in my diet?

Theoretically it should perhaps be possible to do this, balancing your taste for food with an increased amount of insulin. In practice it often just does not work out and the reason for this is that it is difficult to judge each day when you give your injection how much food you are likely to have that day. Also insulin injected beneath the skin works slowly and evenly over a period of hours and cannot cope with a sudden surge of glucose through the system that would follow something like a big piece of cake or can of ordinary soft drink.

Can young people with diabetes have tablets instead of insulin?

In general, no. Almost all children with diabetes require insulin. Tablets occasionally may be added to assist the action of insulin but can’t be given successfully instead of insulin. Some children, in the first few months of their life with diabetes, do respond to tablets, but no form of tablet treatment available at present is suitable for children in the long run.

What would happen if I did not have my insulin injection one morning?

If you missed having an injection for one day you would obviously develop high blood glucose levels and you might become very thirsty and pass excessive quantities of urine, much the same way as you probably did when you first got ill with diabetes. If you did forget your insulin and you realized this during the day you should consult your doctor at once, as he will probably advise you to have a supplementary dose of quick acting insulin to replace some of the insulin you missed. If you do this no harm will be done. If you do not it may take a few days to get re-stabilized.

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