Painkillers and antipyretics in the pediatric practice.

1. Big picture

In pediatrics, pain and fever are not diagnoses. They are symptoms that require two parallel actions:

First: assess whether the child is seriously ill. Second: relieve discomfort safely with age-appropriate, weight-based treatment.

The examiner wants to hear this logic:

Treat the child, not only the number on the thermometer. A playful febrile child may need fluids and observation; a lethargic child with only moderate fever may need emergency evaluation.

For fever, antipyretics are mainly for comfort, not for “normalizing” temperature. Antipyretics do not prevent febrile convulsions, and tepid sponging is not recommended routinely. NICE advises using either paracetamol or ibuprofen only if the child appears distressed, not just to reduce temperature. ([NICE][1])

For pain, the mistake is undertreatment. Children feel pain fully, including neonates. Pain should be measured, treated, and reassessed.

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