A 2 year old patient presented in our ED today with a runny nose and a fever of 102.1F, with no other symptoms. She was cranky, snotty, and tearful. The mother stated that her daughter had had this fever on and off for four days, and that she had been medicating her with Tylenol as instructed to by her doctor, but that the fever had been coming back and not subsiding.

After we had completed our assessment, the doc determined that the kid had a viral infection, and therefore just needed the Tylenol and/or Ibuprofen to keep the fever down until the infection cleared. Now during triage I had given the kid Ibuprofen and in a short time she perked up, her temp went down, and she was running around and laughing. Turns out that the mother was still giving her the same dosage of Tylenol that she had been prescribed back in November, from the same bottle, but the kid had obviously outgrown that dosage and therefore it was not having the desired effect.

I took the time to do some patient education, and it was interesting to see the light bulb go on when she realized that medications for kids are often prescribed by weight, and therefore her kid was simply getting undermedicated because she had outgrown the dosage.

Mom left the ED much happier, and ofcourse the little kid was trotting along, happy as could be... ahh the wonders of tylenol!!