2. Body temperature is the degree of hotness or coldness of a
body.
It is the somatic sensation of heat or cold. It is the degree of
or intensity of heat of a body in relation to external
environment.
The body temperature is the difference between the amount
of heat produced by body processes & the amount of heat
lost to the external environment.
4. Core temperature: it is the temperature of internal body
tissues below the skin & subcutaneous tissues. The
sites of measurement are rectum, tympanic membrane,
esophagus, pulmonary artery & urinary bladder.
5. Surface body temperature- it refers to the body
temperature of external body tissues at the surface
that is of the skin & subcutaneous tissues.
6. It is precisely regulated by physiological & behavioral
mechanisms in number of ways:-
Neural control
Vascular control
Skin in temperature regulation
Behavioral control
8. Fever is an elevation of body temperature that exceeds
normally daily variation and occurs in conjunction with an
increase in the hypothalamic set point for e.g. 37⁰C-
39⁰C.
9. Hot environment.
Excessive exercise.
Neurogenic factors like injury
to hypothalamus.
As an undesired side effect of a
therapeutic drug.
10. Chemical substances e.g. caffeine and cocaine
directly injected into the bloodstream.
Infectious disease and inflammation.
Severe hemorrhage.
11. 1. Intermittent fever: Temperature returns to acceptable
value at least once in 24 hours. The temperature curve
returns to normal during the day and reaches its peak in the
evening. E.g.- in septicemia.
2. Remittent fever: fever spikes & falls without a return to
the normal temperature levels. The temperature fluctuates
but does not return to normal. E.g.- TB, viral diseases,
bacterial infections
12. 3. Sustained fever: the temperature remains continuously
elevated above 38 degree Celsius & demonstrates little
fluctuation.
4. Relapsing fever: periods of febrile periods
interspersed with acceptable temperature values i.e.
periods of fever are interspersed with periods of normal
temperature.
15. Flushed face
hot dry skin
anorexia
headache
nausea and sometimes vomiting
constipation and sometimes diarrhea
body aches
scant highly colored urine.
16. Increased heart rate, respiratory rate and depth
shivering; pale cold skin
cyanotic nail beds
17. It is elevated body temperature due to failed
thermoregulation that occurs when a body produces or
absorbs more heat than it dissipates. Temperature
ranges - >37.5-38.3degree Celsius (99.5- 100.9 degree
Fahrenheit).
18. 1- Heat stroke: prolonged exposure to sun or high
environmental temperatures. These condition causes heat
stroke – a dangerous heat emergency with a high mortality
rate.
19.
20. 2- Drug induced hyperthermia: due to increased use of
psychotropic drugs e.g. Monoamine oxidizes inhibitors,
tricycle antidepressants, amphetamines, phencyclidine,
lysergic acid diethylamide or cocaine, selective serotonin
uptake inhibitors(SSRIs), MAO‘s( Serotonin Syndrome), use
of narcoleptic agents like antipsychotic
phenothiazine's, haloperidol ( NMS).
21. 3- Endocrinopathy: thyrotoxicosis and
pheochromocytoma can lead to increased
thermogenesis
4- Central nervous system damage: cerebral
hemorrhage, status epileptics, hypothalamic injury can
cause hyperthermia
22. Acetaminophen: adult: 325-650 mg PO q 4-6 hrs.
Children: 10-15mg/kg body weight q4-6 hrs.
Ibuprofen (NSAID) - dosage: adult-200-400mg PO
q6hrs; children: 5mg/kg body wt for temp. <102.5F; 10
mg/kg body wt. for temp 102.5F (not to exceed 40
mg/kg/day).
Indomethacin and naproxen (NSAID).
23. Aspirin: adult 325-650 mg PO q6hrs; children 10-20 mg q
6hrs.
Gluco corticosteroid: potent antipyretic inhibit PGE2
synthesis.
Mepridine, morphine sulphate, chlorpromazine used
in severe hyperthermia patient’s.
24. Monitor vital signs.
Assess skin color and temperature.
Monitor white blood cell count, hematocrit value, and
other pertinent laboratory reports for indication of
infection or dehydration.
25. Provide adequate nutrition and fluids to meet the
increased metabolic demands and prevent
dehydration.
Reduce physical activity to limit heat production
especially during the flush stage.
Provide a tepid sponge bath to increase heat loss
through conduction.
Provide dry clothing and bed linens.
26. Remove excess blankets when the patient feels
warm, but provide extra warmth when the patient
feels chilled.
Administer antibiotics as ordered.
27. Fever of Unknown Origin(FUO) was defined by
Peterson & Benson in 1961 as having following features
1) temperature of > 38.3 degree Celsius (>101 degree
Fahrenheit) in several occasions.
2) A duration of fever of > 3 weeks.
3) Failure to reach a diagnosis despite one week of
inpatient investigation.
29. History
Physical examination
Blood investigations-tumor markers, PPD for TB,
serological studies, peripheral smears, multiple samples for
culture and sensitivity
X-Ray studies
Bone marrow biopsy, Liver biopsy
CT scan, MRI, ultrasonography.
30. Continuous observation and examination.
Do not start with immediate Antibiotic Therapy as
it can delineate the cause of FUO.
The debilitating symptoms are treated by NSAIDS
and glucocorticoids.
31. If neutropenia and vital sign instability are present
then empirical therapy with fluroquinolone and
piperacillin is given.
When no underlying source of infection is found even
after 6 months the prognosis is generally good.
32. Hypothermia is a state in which the core body
temperature is lower than 35 degree Celsius and 95
degree Fahrenheit.
At this temperature many of the compensatory
mechanism to conserve heat begin to fall.
33. Normal Range:
96-100º F
Mild Hypothermia:
90-95º F
SevereHypothermia
< 90º F
34. Exposure to cold environment in winter months and
colder climates.
Occupational exposure or hobbies that entail
extensive exposure to cold, e.g. hunters, skiers,
sailors and climbers.
Endocrine dysfunction: hypothyroidism, adrenal
insufficiency , hypoglycemia
36. MILD Hypothermia:
Lethargy
Shivering
Lack of Coordination
Pale, cold, dry skin
Early rise in heart rate, and respiratory rates.
37. SEVERE Hypothermia:
No shivering
Heart rhythm problems
Cardiac arrest
Loss of voluntary muscle control
Low blood pressure
Undetectable pulse and respirations
39. PASSIVE: involves the use of blankets to cover body and
head to trap heat being lost.
ACTIVE: the application of outside heat to raise body
temperature
External – heat blanket/forced hot air system
Internal – introduction of warm fluids into the body
Warm IVF, body cavity lavage, extracorporeal
40. Frost bite is the condition in which the tissue
temperature drops below 0 degree Celsius. It results in
cellular and vascular damage.
Body parts more frequently affected by frostbite include
the digits of feet and hands, tip of nose, and earlobes.
41. Contact with thermal conductors such as metal or
volatile solutions
immobility
careless application of cold packs
vasoconstrictive medications
42. First degree frost bite: causes only anesthesia and
erythematic tissue.
Second degree frost bite: appearance of superficial
vesiculation surrounded by edema.
43. Third degree frost bite: hemorrhagic vesicles due to
serious microvasculature injury which further leads to
cyanosis.
Fourth degree frost bite: damage in sub cuticular,
muscular and osseous tissue.
44.
45. Before thawing:
• remove patient from cold environment.
• stabilize core temperature.
• treat hypothermia.
• protect the frozen part and do not apply friction or
massage.
46. During thawing:
• provide parental analgesia e.g. keratolac & Provide
ibuprofen 40 mg PO.
• Immerse part in 37-40 C circulating water containing an
antiseptic soap for 10-45 minutes.
• Encourage patient to gently move the part.
47. After thawing:
a) gently dry and elevate it.
b) Apply pledges between toes.
c) If clear vesicles are intact aspirate the fluid or the fluid will
reabsorb in days; if broken then debride and dress with
antibiotic.
d) Continue analgesics Ibuprofen 400mg 8-12 hourly. Provide
tetanus prophylaxis and hydrotherapy at 37C.
e) The patient should be stimulated with orally administered
hot fluids such as tea and coffee.
f) The patient should not be allowed to smoke.
g) Artificial respiration should be administered if the patient
is unconscious.
