For fever management in a child, which antipyretic is appropriate in prehospital care?

• A. Aspirin
• B. No fever management
• C. Acetaminophen or ibuprofen
• D. Antibiotics only

Answer: (C)

Fever management in a child centers on using safe, effective fever-reducing medications that are appropriate for pediatric use in the prehospital setting. Acetaminophen or ibuprofen are appropriate options because both can lower fever and relieve discomfort in most children. Aspirin, however, is avoided in children due to the risk of Reye’s syndrome, a rare but serious complication associated with viral illnesses when aspirin is used. Opting for no fever management isn’t ideal, since fever can cause ongoing discomfort and dehydration, and specific antipyretics provide symptom relief. Antibiotics are not antipyretics and should not be given solely to reduce fever unless there is a confirmed bacterial infection requiring antibiotic therapy. When using either acetaminophen or ibuprofen, tailor the choice to the child’s age and weight, follow weight-based dosing and dosing intervals, and be mindful of contraindications (acetaminophen for those with liver disease; ibuprofen not suitable for dehydration or certain kidney or GI conditions or in very young infants). In many prehospital protocols, acetaminophen is a common first-line option, with ibuprofen available as an alternative when appropriate.