Fever is characterized not only by an increase in temperature, but also by a violation of the activity of all body systems. The degree of temperature rise is important, but not always decisive, in assessing the severity of the fever.

Fever symptoms:

fast and strong rise temperature (for example, with pneumonia) is usually accompanied by chills, which can last from several minutes to an hour, less often longer.
With a strong chill, the appearance of the patient is characteristic: due to a sharp narrowing of the blood vessels, the skin becomes pale, the nail plates become cyanotic. Experiencing a feeling of cold, patients tremble, chatter their teeth. A slight chilling is characteristic of a gradual increase in temperature. At high temperatures, the skin has a characteristic appearance: red, warm ("fiery"). A gradual drop in temperature is accompanied by profuse sweat. In fever, evening body temperature is usually higher than morning. The rise in temperature above 37 ° C during the day is a reason to suspect the disease.

Types of fevers:

Types of fevers:

The main types of fever:
constant fever - the temperature remains high for a long time, during the day the difference between morning and evening temperatures does not exceed 1 ° C; characteristic of lobar pneumonia, stage II of typhoid fever;
laxative (remitting) fever - the temperature is high, daily temperature fluctuations exceed 1-2 ° C, and the morning minimum is above 37 ° C; characteristic of tuberculosis, purulent diseases, focal pneumonia, stage III typhoid fever;
debilitating (hectic) fever - large (3-4 ° C) daily temperature fluctuations, alternating with its fall to normal and below, which is accompanied by debilitating sweats; typical of severe pulmonary tuberculosis, suppuration, sepsis;
intermittent (intermittent) fever - short-term temperature rises to high numbers strictly alternate with periods (1-2 days) of normal temperature; observed in malaria;
undulating (undulating) fever - periodic rises in temperature, and then a decrease in the level to normal numbers, such "waves" follow one after another for a long time; characteristic of brucellosis, lymphogranulomatosis;
relapsing fever - a strict alternation of periods of high temperature with fever-free periods, while the temperature rises and falls very quickly, febrile and fever-free phases last for several days each, characteristic of relapsing fever;
reverse type of fever - morning temperature is higher than evening; sometimes observed in sepsis, tuberculosis, brucellosis;
irregular fever - varied and irregular daily fluctuations; often observed in rheumatism, endocarditis, sepsis, tuberculosis, this fever is also called atypical (irregular).

During a fever, there is a period of rise in temperature, a period of high temperature and a period of decrease in temperature. A sharp decline elevated temperature (within a few hours) to normal is called a crisis, a gradual decrease (over several days) is called lysis.

Fever stages:

With severe chills, the appearance of the patient is characteristic: the skin is pale due to a sharp capillary spasm, peripheral cyanosis is noted, muscle tremors may be accompanied by tapping of the teeth.

The second stage of fever is characterized by the cessation of temperature rise, heat transfer is balanced with heat production. Peripheral circulation is restored, the skin becomes warm to the touch and even hot, the pallor of the skin is replaced by a bright pink color. Sweating also increases.

In the third stage, heat transfer prevails over heat production, skin blood vessels expand, sweating continues to grow. The decrease in body temperature can proceed quickly and abruptly (critically) or gradually.

Sometimes there is a short-term increase in temperature for several hours (one-day, or ephemeral fever) with mild infections, overheating in the sun, after blood transfusion, sometimes after intravenous administration of drugs. Fever lasting up to 15 days is called acute, lasting more than 45 days - chronic.

Causes of fever:

The degree of temperature rise largely depends on the patient's body: with the same disease in different individuals, it can be different. So, in young people with a high reactivity of the body, an infectious disease can occur with a temperature of up to 40 ° C and above, while the same infectious disease in older people with a weakened reactivity can occur with a normal or slightly elevated temperature. The degree of temperature rise does not always correspond to the severity of the disease, which is also associated with the individual characteristics of the body's response.

Fever infectious diseases is the earliest and most typical reaction to the introduction of a microbial agent. In this case, bacterial toxins or waste products of microorganisms (viruses) are exogenous pyrogens. They also cause another protective reaction, which consists in the development of stress mechanisms with increased release of neutrophilic leukocytes.

An increase in temperature of non-infectious origin is often observed with malignant tumors, tissue necrosis (for example, with a heart attack), hemorrhages, rapid disintegration of red blood cells in the blood, subcutaneous or intravenous administration of foreign substances of a protein nature. Fever is much less common in diseases of the central nervous system, as well as reflex origin. At the same time, temperature rises are more often observed in the daytime, so it becomes necessary to measure it hourly.

Fever of central origin can be observed with injuries and diseases of the central nervous system, it is characterized by a severe malignant course. High fever can develop without the participation of pyrogens with severe emotional stress.

Fever is characterized not only by the development of high temperature, but also by a violation of the activity of all body systems. The maximum level of the temperature curve is important, but not always decisive, in assessing the severity of fever.

In addition to high temperature, fever is accompanied by an increase in heart rate and respiration, a decrease in blood pressure, the occurrence of general symptoms of intoxication: headache, malaise, feelings of heat and thirst, dry mouth, lack of appetite; decrease in urination, increased metabolism due to catabolic processes. At the peak of a febrile state, confusion, hallucinations, delirium, up to a complete loss of consciousness, can be observed in some cases. However, for the most part, these phenomena reflect the characteristics of the course of the infectious process itself, and not just the febrile reaction.

The pulse rate during fever is directly related to the level of high temperature only in benign fevers caused by low-toxic pyrogens. This does not happen with all infectious diseases. For example, typhoid fever is characterized by a pronounced decrease in heart rate against the background of severe fever. In such cases, the effect of high temperature on the frequency heart rate weakens under the influence of other causative factors and mechanisms of the development of the disease. The frequency of respiratory movements also increases with the development of high temperature. At the same time, breathing becomes more shallow. However, the severity of the decrease in breathing does not always correspond to the level of high temperature and is subject to significant fluctuations.

In the febrile period, the function of the digestive tract is always disturbed in patients. Usually, appetite is completely absent, which is associated with a decrease in digestion and assimilation of food. The tongue is covered with a coating of various shades (usually white), patients complain of dry mouth.

The volume of the secretion of the digestive glands (salivary, gastric, pancreas, etc.) is significantly reduced. Disturbances in the motor function of the gastrointestinal tract are expressed in various kinds of disorders of motor functions, usually with a predominance of spastic phenomena. As a result, the promotion of intestinal contents slows down significantly, as does the release of bile, the concentration of which increases.

There are no noticeable changes in the activity of the kidneys during fever. An increase in daily urination in the first stage (an increase in temperature rise) depends on an increase in blood flow in the kidneys due to the redistribution of blood in the tissues. On the contrary, a slight decrease in urination with an increase in urine concentration at the height of the febrile reaction is due to fluid retention.

One of the most important components of the protective and adaptive mechanism of fever is an increase in the phagocytic activity of leukocytes and tissue macrophages, and, most importantly, an increase in the intensity of antibody production is noted. Activation of cellular and humoral mechanisms of immunity allows the body to adequately respond to the introduction of foreign agents and stop infectious inflammation.

High temperature itself can create unfavorable conditions for the reproduction of various pathogens and viruses. In the light of the above, the purpose of developing a feverish reaction developed in the course of evolution is understandable. That is why fever is a non-specific symptom a large number a variety of infectious diseases.

Diagnosis and differential diagnosis of fever:

The duration of the febrile period makes it possible to divide all such conditions into short-term (acute) and long-term (chronic). The former include a high temperature lasting no more than two weeks, the latter - more than two weeks.

Acute fevers lasting no more than one week most often occur due to various viral infections of the upper respiratory tract and stop on their own without outside intervention. A number of short-term bacterial infections also cause acute fever. Most often they affect the pharynx, larynx, middle ear, bronchi, genitourinary system.

If the fever persists for a longer time, then even with the seeming clarity of the clinical picture, the patient requires a more thorough examination. If prolonged fever does not correspond to other clinical manifestations or the general condition of the patient, the term "fever of unknown etiology" (FUE) is usually used.

The following febrile states are distinguished:
A. Acute:
I. Viral.
II. Bacterial.
B. Chronic:
I. Infectious:
viral (infectious mononucleosis, viral hepatitis B, cytomegalovirus infection, HIV);
bacterial (tuberculosis, brucellosis, septic endocarditis, etc.);
in individuals with secondary immunodeficiency.
II. Tumor.
III. With systemic diseases of the connective tissue.
IV. With other conditions and diseases (endocrine, allergic, increased sensitivity threshold of the thermoregulation center).

Diseases and diseases, causes of fever:

Non-infectious causes of prolonged fever occur in no more than one third of cases. These include fever in subacute septic endocarditis, which is difficult to diagnose in the initial absence of heart murmurs. In addition, blood cultures in 15% of cases do not reveal the presence of bacteria in the blood. Often there are no peripheral signs of the disease (enlargement of the spleen, Osler's nodules, etc.).

For purulent infection:

About 20-40% of fevers of unclear etiology (with an unclear factor of occurrence) may be due to systemic connective tissue pathology (systemic lupus erythematosus, systemic scleroderma, rheumatoid arthritis, Sjögren's disease, etc.). Among other causes, the most important are tumor processes. Among the latter, a special place is occupied by tumors originating from the hematopoietic system (leukemia, lymphogranulomatosis, etc.). In some cases, fever may be due to the addition of an infection, as, for example, with bronchus carcinoma, when obstruction (difficulty breathing) and pneumonia develop in the underlying lung.

With pathology of the endocrine system:

The mandatory minimum laboratory tests for long-term febrile patients include general analysis blood with the calculation of the leukocyte formula, the determination of malarial plasmodium in a smear, tests of the functional state of the liver, bacteriological cultures of urine, feces and blood up to 3-6 times. In addition, it is necessary to carry out the Wasserman reaction, tuberculin and streptokinase tests, a serological test for HIV, as well as an X-ray examination of the lungs and ultrasound of the abdominal organs.

Even the presence of minor complaints of moderate headache, a mild change in mental status require a puncture of the cerebrospinal fluid with its subsequent study. In the future, if the diagnosis remains unclear, based on the results of the initial examination, the patient should be determined for such signs as anti-nuclear antibodies, rheumatoid factor, antibodies to brucella, salmonella, toxoplasma, histoplasm, Epstein-Barr virus, cytomegaly, etc., as well as to conduct a study on fungal diseases (candidiasis, aspergillosis, trichophytosis).

The next stage of the examination with an undetermined diagnosis in a patient with a long-term fever is a computed tomography, which allows localizing tumor changes or abscesses. internal organs, as well as intravenous pyelography, puncture and seeding of the bone marrow, endoscopy of the gastrointestinal tract.

If the cause of prolonged fever cannot be determined, it is recommended that such patients be given trial treatment, usually represented by antibiotic therapy or specific anti-tuberculosis drugs. If the patient is already receiving treatment, it should be canceled for a while to exclude the medicinal nature of the fever.

drug fever:

Fever with tumors:

In addition to staphylococcus aureus, streptococcus, and anaerobes, fungi of the genus Candida and aspergillus, pneumocystis, toxoplasma, listeria, legionella, cytomegaloviruses, and herpes viruses can be causative agents of diseases in inpatients with immunodeficiency. Examination of such patients should begin with a bacteriological examination of blood cultures, urine, feces and sputum, as well as cerebrospinal fluid (depending on the clinical manifestations of the infection).

It is often necessary to start antibiotic therapy before culture results are available. In such cases, one should focus on the most characteristic nature of the pathogen for a given localization of infection in a patient (streptococci and Escherichia coli, as well as anaerobes in enterocolitis, Escherichia coli and Proteus for urinary tract infections).

To recognize the causes of acute fevers, the nature of the rise in temperature, its frequency and height, as well as the duration of the various periods of fever, are of paramount importance. Different duration of the period of temperature increase can be a characteristic sign of a number of acute infectious processes. For example, for brucellosis and typhoid fever, a gradual increase in the temperature curve over several days to a maximum is typical.

Influenza, typhus, measles and most viral diseases of the respiratory tract are characterized by a short - no more than a day - period of temperature rise to high numbers. The most acute onset of the disease, when the temperature reaches its maximum in a few hours, is characteristic of meningococcal infection, relapsing fever, and malaria. In the differential diagnosis of the causes of febrile conditions, one should rely not only on one symptom (fever), but on the entire symptom complex of the features of the course of a period of high temperature.

For rickettsiosis, a combination of acute development of fever with persistent headache and insomnia, as well as redness of the face and motor excitation of the patient, is typical. The appearance of a typical rash on the 4th-5th day of the disease makes it possible to diagnose the clinic of typhus.

For typhus:

This is observed at the height of the disease. On the 8-10th day of illness, patients with typhus may also experience a "cut" in the temperature curve, similar to the first. But then after 3-4 days the temperature drops to normal. When using antibiotic therapy, typical febrile reactions are rare. In uncomplicated typhus, fever usually lasts 2-3 days, less often - 4 days or more.

Borelliosis (relapsing lousy and tick-borne typhus) are characterized by a rapid rise in temperature to high numbers, accompanied by severe symptoms of intoxication and tremendous chills. Within 5-7 days, the high temperature remains at the achieved level, after which it critically decreases to normal numbers, and then after 7-8 days the cycle repeats.

For typhoid fever:

For leptospirosis:

For malaria:

Erysipelas is also characterized by an acute onset and the absence of a previous period. The temperature rise reaches 39-40°C, may be accompanied by vomiting, agitation. Usually, pain and burning sensation immediately appear in the area of ​​the affected area of ​​the skin, which soon acquires a bright red color with a roller that sharply limits the area of ​​​​inflammation.

For meningitis:

With meningococcal infection, body temperature can range from slightly elevated to very high (up to 42 ° C). The temperature curve can be of constant, intermittent and remitting type. Against the background of antibiotic therapy, the temperature decreases by the 2-3rd day, in some patients a slightly elevated temperature persists for another 1-2 days.

Meningococcemia (meningococcal sepsis) begins acutely and proceeds rapidly. A characteristic symptom is a hemorrhagic rash in the form of asterisks. irregular shape. The elements of the rash in the same patient can be of different sizes - from small punctures to extensive hemorrhages. The rash appears 5-15 hours after the onset of the disease. Fever in meningococcemia is often intermittent. The symptoms of intoxication are pronounced, the temperature rises to 40-41 ° C, severe chills, headache, hemorrhagic rash, palpitations, shortness of breath, cyanosis appear. Then the blood pressure drops sharply. Body temperature drops to normal or slightly elevated numbers. Motor excitation increases, convulsions appear. And in the absence of appropriate treatment, death occurs.

Meningitis can be of more than just meningococcal origin. Meningitis, like encephalitis (inflammation of the brain), develops as a complication of any past infection. So, the most harmless, at first glance, viral infections, such as influenza, chicken pox, rubella, can be complicated by severe encephalitis. The body temperature is usually high sharp deterioration general condition, there are cerebral disorders, headache, dizziness, nausea, vomiting, impaired consciousness, general anxiety. Depending on the damage to a particular part of the brain, various symptoms can be detected - disorders of the cranial nerves, paralysis.

Hemorrhagic fevers:

Flu fever:

Fever with measles in adults:

The headache is moderate, and excessive sweating (or heavy sweating) is typical. There is an increase in all groups of lymph nodes, an increase in the liver and spleen. The disease usually begins gradually, rarely acutely. Fever in the same patient may be different. Sometimes the disease is accompanied by a wavy temperature curve of a remitting type, typical of brucellosis, when fluctuations between morning and evening temperatures are more than 1 ° C, intermittent - a decrease in temperature from high to normal or constant - fluctuations between morning and evening temperatures do not exceed 1 ° C.

Feverish waves are accompanied by profuse sweating. The number of waves of fever, their duration and intensity are different. Intervals between waves - from 3-5 days to several weeks and months. Fever may be high, long low-grade, and may be normal. The disease often occurs with prolonged subfebrile condition. Characteristic is the change of a long febrile period by a fever-free interval, also of varying duration. Despite the high temperature, the condition of the patients remains satisfactory. With brucellosis, damage to various organs and systems is noted, primarily the musculoskeletal, urogenital (genitourinary), nervous systems suffer, the liver and spleen increase.

For yersinosis:

For infectious mononucleosis:

Fever in poliomyelitis:

For ornithosis:

Fever with tuberculosis:

For sepsis:

An increase in body temperature can be observed in various diseases of the lungs, heart, and other organs. So, inflammation of the bronchi (acute bronchitis) can occur in acute infectious diseases (flu, measles, whooping cough, etc.) and when the body is cooled. Body temperature in acute focal bronchitis can be slightly elevated or normal, and in severe cases it can rise to 38-39 ° C. There is also weakness, sweating, coughing.

The development of focal pneumonia (pneumonia) is associated with the transition of the inflammatory process from the bronchi to the lung tissue. They can be of bacterial, viral, fungal origin. The most characteristic symptoms of focal pneumonia are cough, fever and shortness of breath. Fever in patients with bronchopneumonia is of varying duration. The temperature curve is often of a relieving type (daily temperature fluctuations of 1 ° C, with a morning minimum above 38 ° C) or of the wrong type. Often the temperature is slightly elevated, and in the elderly and senile age it may be completely absent.

Croupous pneumonia is more often observed with hypothermia. Lobar pneumonia is characterized by a certain cyclical course. The disease begins acutely, with a tremendous chill, fever up to 39-40°C. Chills usually last up to 1-3 hours. The condition is very serious. Shortness of breath, cyanosis are noted. In the stage of the height of the disease, the condition of patients worsens even more. Symptoms of intoxication are expressed, breathing is frequent, shallow, tachycardia up to 100/200 beats / min.

Against the background of severe intoxication, vascular collapse may develop, which is characterized by a drop in blood pressure, increased heart rate, shortness of breath. Body temperature also drops sharply. The nervous system suffers (sleep is disturbed, there may be hallucinations, delirium). With lobar pneumonia, if antibiotic treatment is not started, the fever can last for 9-11 days and be permanent. The drop in temperature can occur critically (within 12-24 hours) or gradually, over 2-3 days. In the stage of resolution of fever usually does not happen. Body temperature returns to normal.

For rheumatism:

The temperature curve is remittent in nature, accompanied by weakness, sweating. A few days later, pain in the joints appears. Rheumatism is characterized by damage to the heart muscle with the development of myocarditis. The patient is worried about shortness of breath, pain in the heart, palpitations. There may be a slight increase in body temperature. The feverish period depends on the severity of the disease. Myocarditis can also develop with other infections - scarlet fever, diphtheria, pikketeiosis, viral infections. Allergic myocarditis may occur, for example, with the use of various drugs.

For endocarditis:

Diagnosis of primary bacterial endocarditis presents particular difficulties, since at the beginning of the disease there is no lesion of the valvular apparatus, and the only manifestation of the disease is a fever of the wrong type, accompanied by chills, followed by profuse sweating and a decrease in temperature. Sometimes the rise in temperature can be observed during the day or at night. Bacterial endocarditis can develop in patients with artificial heart valves. In some cases, there are fevers due to the development of a septic process in patients with catheters in the subclavian veins, which are used in infusion therapy.

With damage to the biliary system:

For kidney disease:

For tumor diseases:

Often, fever is the only symptom of a malignant disease. Feverish conditions are often found in malignant tumors of the liver, stomach, intestines, lungs, prostate gland. There are cases when fever for a long time was the only symptom of malignant lymphoma with localization in the retroperitoneal lymph nodes. The main causes of fever in cancer patients are considered to be the addition of infectious complications, tumor growth and the effect of tumor tissue on the body. The third place in the frequency of febrile conditions is occupied by systemic diseases of the connective tissue (collagenosis). This group includes systemic lupus erythematosus, scleroderma, nodular arteritis, dermatomyositis, rheumatoid arthritis.

Systemic lupus erythematosus is characterized by a steady progression of the process, sometimes quite long remissions. In the acute period there is always a fever of the wrong type, sometimes taking on a hectic character with chills and profuse sweat. Dystrophy, damage to the skin, joints, various organs and systems are characteristic.

For systemic vasculitis:

Among patients with prolonged fever, drug fever occurs in 5-7% of cases. It can occur on any medications, more often on the 7-9th day of treatment. Diagnosis is facilitated by the absence of an infectious or somatic disease, the appearance of a papular rash on the skin, which coincides in time with the medication. This fever is characterized by one feature: the symptoms of the underlying disease disappear during therapy, and the body temperature rises. After discontinuation of the drug, body temperature usually returns to normal after 2-3 days.

With endocrine diseases:

The disorder of thermoregulation is manifested by an almost constant feeling of heat, intolerance to heat, thermal procedures, slightly elevated body temperature. An increase in temperature to high numbers (up to 40 ° C and above) is characteristic of a complication of diffuse toxic goiter - a thyrotoxic crisis that occurs in patients with a severe form of the disease. Sharply exacerbated all the symptoms of thyrotoxicosis. There is a pronounced excitation, reaching psychosis, the pulse quickens to 150-200 beats / min. The skin of the face is reddened, hot, moist, the extremities are cyanotic. Muscle weakness, trembling of the limbs develop, paralysis, paresis are expressed.

Acute purulent thyroiditis is a purulent inflammation of the thyroid gland. It can be caused by various bacteria - staphylococcus, streptococcus, pneumococcus, Escherichia coli. It occurs as a complication of purulent infection, pneumonia, scarlet fever, abscesses. The clinical picture is characterized by an acute onset, an increase in body temperature up to 39-40 ° C, chills, palpitations, severe pain in the neck, shifting to the lower jaw, ears, aggravated by swallowing, moving the head. The skin over the enlarged and sharply painful thyroid gland is reddened. The duration of the disease is 1.5-2 months.

With polyneuritis:

In allergic polyneuritis, which develops after the introduction of an anti-rabies vaccine (used to prevent rabies), an increase in body temperature may also be noted. Within 3-6 days after administration, high body temperature, indomitable vomiting, headache, and impaired consciousness can be observed. There are constitutionally conditioned hypothalamopathy ("habitual fever"). This fever has a hereditary predisposition, it is more common in young women. Against the background of vegetovascular dystonia and constant subfebrile condition, there is an increase in body temperature to 38-38.5°C. The rise in temperature is associated with physical exertion or emotional stress.

With artificial fever:

The diagnosis of "artificial fever" can be suspected only after observing the patient, examining him and excluding other causes and diseases that cause an increase in body temperature. Fever can be observed in various acute surgical diseases (appendicitis, peritonitis, osteomyelitis, etc.) and is associated with the penetration of microbes and their toxins into the body. A significant increase in temperature in postoperative period may be due to the body's response to surgical trauma.

When muscles and tissues are injured, the temperature may increase as a result of the breakdown of muscle proteins and the formation of autoantibodies. Mechanical irritation of the centers of thermoregulation (fracture of the base of the skull) is often accompanied by an increase in temperature. With intracranial hemorrhages (in newborns), postencephalitic lesions of the brain, a high temperature is also noted, mainly as a result of a central violation of thermoregulation.

For acute appendicitis:

With suppuration of the appendicular inflammatory compaction, a periappendicular abscess is formed. The condition of the patients is deteriorating. Body temperature becomes high, hectic. Sudden changes in temperature are accompanied by chills. The pain in the abdomen gets worse. A formidable complication of acute appendicitis is diffuse purulent peritonitis. Abdominal pains are diffuse. The condition of the patients is severe. There is a significant increase in heart rate, and the pulse rate does not correspond to body temperature. Brain injuries are open (with damage to the bones of the skull, brain substance) and closed. Closed injuries include concussion, contusion and concussion with compression.

For a concussion:

With sun and heat stroke, general overheating of the body is not necessary. Violation of thermoregulation occurs due to exposure to direct sunlight on an uncovered head or naked body. Disturbed by weakness, dizziness, headache, nausea, sometimes vomiting and diarrhea may occur. In severe cases, excitement, delirium, convulsions, loss of consciousness are possible. High temperature, as a rule, does not happen.

Fever treatment:

Physical means include methods that provide cooling of the body: it is recommended to take off your clothes, wipe the skin with water, alcohol, a 3% vinegar solution, you can apply ice to the head. On the wrists, a bandage moistened with cold water can be applied to the head. Also apply gastric lavage through a probe with cold water (temperature 4-5 ° C), put cleansing enemas, also with cool water. In the case of infusion therapy, all solutions are administered intravenously cooled to 4°C. The patient can be blown with a fan to reduce body temperature. These activities allow you to reduce body temperature by 1-2 ° C for 15-20 minutes. You should not lower the body temperature below 37.5 ° C, because after that it continues to decrease on its own.

As medications apply analgin, acetylsalicylic acid, brufen. It is most effective to use the drug intramuscularly. So, a 50% solution of analgin, 2.0 ml is used (for children - at a dose of 0.1 ml per year of life) in combination with antihistamines: 1% diphenhydramine solution, 2.5% pipolfen solution or 2 % suprastin solution. To reduce body temperature and reduce anxiety, a 0.05% solution of chlorpromazine orally can be used. Children under 1 year old - 1 tsp each, from 1 year to 5 years old - 1 des. l., 1-3 times a day. To prepare a 0.05% solution of chlorpromazine, take an ampoule of a 2.5% solution of chlorpromazine and dilute the 2 ml contained in it with 50 ml of water.

In a more severe condition, to reduce the excitability of the central nervous system, lytic mixtures are used, which include chlorpromazine in combination with antihistamines and novocaine (1 ml of a 2.5% solution of chlorpromazine, 1 ml of a 2.5% solution of pipolfen, 0 5% novocaine solution). A single dose of the mixture for children is 0.1-0.15 ml / kg of body weight, intramuscularly.

To maintain the function of the adrenal glands and with a decrease in blood pressure, corticosteroids are used - hydrocortisone (for children, 3-5 mg per 1 kg of body weight) or prednisolone (1-2 mg per 1 kg of body weight). In the presence of respiratory disorders and heart failure, therapy should be aimed at eliminating these syndromes. With an increase in body temperature to high numbers, children may develop a convulsive syndrome, to stop which seduxen is used (children under 1 year old at a dose of 0.05-0.1 ml; 1-5 years old - 0.15-0.5 ml 0, 5% solution, intramuscularly).

To combat cerebral edema, magnesium sulfate 25% solution is used at a dose of 1 ml per year of life intramuscularly. First aid for heat and sunstroke comes down to the following. It is necessary to immediately stop exposure to factors that led to sun or heat stroke. It is necessary to transfer the victim to a cool place, remove clothes, lay down, raise his head. The body and head are cooled by applying compresses with cold water or pouring cold water over them.

The victim is given a sniff of ammonia, inside - soothing and heart drops (Zelenin drops, valerian, Corvalol). The patient is given a plentiful cool drink. When respiratory and cardiac activity stops, it is necessary to immediately release the upper respiratory tract from vomit and begin artificial respiration and heart massage until the first respiratory movements and cardiac activity appear (determined by pulse). The patient is urgently admitted to the hospital.