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A&E departments ‘overwhelmed’ by children with mild fevers, creating ‘winter in June’ for NHS

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Hospital A&E departments are being “overwhelmed” by children being brought in with often nothing more than a mild fever, experts have said.

The increase is creating “winter in June” for the NHS and three royal colleges have issued new guidance for parents, after seeing a large rise in the numbers seeking emergency help for conditions that are not COVID-19.

As lockdown eases, more children are mixing and coming into contact with viruses usually seen in the winter months.

These include a range of respiratory infections, bronchiolitis, para flu and rhinovirus, all of which produce symptoms of cough, runny nose and fever.

The Royal College of Paediatrics and Child Health (RCPCH) said conditions are usually mild but it has heard from emergency doctors around the country that there has been a large increase in children being brought in by anxious parents.

Dr Camilla Kingdon, president of the RCPCH, said many parents have not seen a fever in their children, especially those born during lockdown.

“Many emergency departments are currently overwhelmed and there has been a particularly steep rise in the number of young children presenting,” Dr Kingdon said.

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“Some have seen the highest ever numbers of children in their department and waiting times can be huge.

“The biggest increase we’re seeing is in children with mild fever. Fevers are very common in young children and usually aren’t serious.

A&E sign
Image: Attendances for those aged 15 and under rose from 2018 to this year by 48%

“But many parents haven’t seen fever in their child before and are worried, particularly if they don’t have their usual sources of support to turn to, such as parent groups.”

One emergency paediatrician described the situation as “winter in June”, with data from four hospitals showing May attendances for those aged 15 and under rose from 15,954 in 2018 to 23,661 this year – a 48.3% increase.

Dr Dan Magnus, a consultant in paediatric emergency medicine at the Bristol Royal Hospital, said: “We had an incredibly busy week last week – in fact on Monday we set a new record for the number of children seen in 24 hpurs in our department ever, and that’s in the middle of summer.

“We are effectively running a winter-level ED (emergency department) response in the summertime.”

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The RCPCH, the Royal College of Emergency Medicine (RCEM) and the Royal College of GPs have issued advice on how parents can treat children with mild fever and when to seek help.

They say that, for most children, treatment with children’s paracetamol or ibuprofen (but not both at the same time) is usually enough to reduce the fever and the child will start to feel better after a few days.

Parents should also ensure children stay hydrated by drinking clear fluids like water or squash.

The experts stressed that parents should always seek medical advice for the child if:

• The baby is under three months old and has a temperature of 38C (101F) or higher

• The baby is three to six months old and has a temperature of 39C (102F) or higher

• The child is not drinking well or is dehydrated. For a baby, this means that they are taking less than half of their normal feeds and having less than two wet nappies a day

• A child develops a red rash that does not fade when a glass is rolled over it, has a fit or is crying constantly and cannot be consoled or distracted. If the cry does not sound normal (such as high pitched), advice should also be sought

• The fever lasts for more than five days or the child is becoming more unwell