Fever is characterized not only by an increase in temperature, but also by disruption of all body systems. The degree of temperature increase is important, but not always crucial to assess the severity of fever.

Symptoms of fever:

A rapid and severe increase in temperature (for example, with pneumonia) is usually accompanied by chills, which can last from several minutes to an hour, rarely longer.
With severe chills, the patient's appearance is characteristic: due to a sharp narrowing of the blood vessels, the skin becomes pale, the nail plates acquire a bluish color. Feeling cold, patients tremble and chatter their teeth. A gradual increase in temperature is characterized by slight chilling. At high temperatures, the skin has a characteristic appearance: red, warm (“fiery”). A gradual drop in temperature is accompanied by profuse sweat. With fever, the evening body temperature is usually higher than the morning. A rise in temperature above 37°C during the day is a reason to suspect the disease.

Types of fevers:

Types of fevers:

Main types of fever:
constant fever - the temperature remains high for a long time, during the day the difference between morning and evening temperatures does not exceed 1°C; typical for lobar pneumonia, stage II typhoid fever;
laxative (remitting) fever - high temperature, daily temperature fluctuations exceed 1-2°C, with a morning minimum above 37°C; characteristic of tuberculosis, purulent diseases, focal pneumonia, in stage III of typhoid fever;
debilitating (hectic) fever - large (3-4°C) daily temperature fluctuations, alternating with a drop to normal or below, which is accompanied by debilitating sweats; typical for severe pulmonary tuberculosis, suppuration, sepsis;
intermittent (intermittent) fever - short-term increases in temperature to high numbers strictly alternate with periods (1-2 days) of normal temperature; observed in malaria;
undulating (undulating) fever - periodic increases in temperature, and then a decrease in the level to normal numbers, such “waves” follow one after another for a long time; characteristic of brucellosis, lymphogranulomatosis;
relapsing fever - a strict alternation of periods of high temperature with non-febrile periods, while the temperature rises and falls very quickly, febrile and non-febrile phases last for several days each, characteristic of relapsing fever;
reverse type of fever - morning temperature is higher than evening temperature; sometimes observed in sepsis, tuberculosis, brucellosis;
irregular fever - varied and irregular daily fluctuations; often observed in rheumatism, endocarditis, sepsis, tuberculosis; this fever is also called atypical (irregular).

During a fever, there is a period of increasing temperature, a period of high temperature and a period of decreasing temperature.
A sharp decline An elevated temperature (within several hours) to normal is called a crisis, a gradual decrease (over several days) is called lysis.

Stages of fever:

With severe chills, the patient's appearance is characteristic: the skin is pale due to sharp capillary spasm, peripheral cyanosis is noted, muscle tremors may be accompanied by chattering of the teeth.

The second stage of fever is characterized by the cessation of temperature rise, heat transfer is balanced with heat production. Peripheral circulation is restored, the skin becomes warm to the touch and even hot, the pallor of the skin is replaced by a bright pink color. Sweating also increases.

In the third stage, heat transfer prevails over heat production, skin blood vessels dilate, and sweating continues to increase. The decrease in body temperature can occur quickly and sharply (critically) or gradually.

Sometimes there is a short-term increase in temperature for several hours (one-day, or ephemeral fever) with mild infections, overheating in the sun, after a blood transfusion, sometimes after intravenous administration medicinal substances. Fever lasting up to 15 days is called acute; fever lasting more than 45 days is called chronic.

Causes of fever:

The degree of temperature increase largely depends on the patient’s body: for the same disease, different persons it may be different. Thus, in young people with high reactivity of the body, an infectious disease can occur with a temperature of up to 40 ° C and above, while the same infectious disease in older people with weakened reactivity can occur with a normal or slightly elevated temperature. The degree of temperature increase does not always correspond to the severity of the disease, which is also associated with individual characteristics body reaction.

Fever in infectious diseases is the earliest and most typical reaction to the introduction of a microbial agent. In this case, bacterial toxins or waste products of microorganisms (viruses) are exogenous pyrogens. They also cause another defensive reaction, which consists in the development of stress mechanisms with increased release of neutrophilic leukocytes.

An increase in temperature of non-infectious origin is often observed with malignant tumors, tissue necrosis (for example, during a heart attack), hemorrhages, rapid breakdown of red blood cells in the blood, and the subcutaneous or intravenous administration of foreign protein substances. Fever is much less common in diseases of the central nervous system, as well as of reflex origin. At the same time, temperature rises are more often observed in the daytime, so there is a need to measure it hourly.

Fever of central origin can be observed with injuries and diseases of the central nervous system; it has a severe malignant course. Heat can develop without the participation of pyrogens during severe emotional stress.

Fever is characterized not only by the development of high temperature, but also by disruption of the functioning of all body systems. The maximum level of the temperature curve is important, but not always decisive, for assessing the severity of fever.

In addition to high temperature, fever is accompanied by increased heart rate and breathing, decreased blood pressure, and the appearance of general symptoms of intoxication: headache, malaise, feelings of heat and thirst, dry mouth, lack of appetite; decreased urine output, increased metabolism due to catabolic processes. At the peak of a febrile state, in some cases, confusion, hallucinations, delirium, and even complete loss of consciousness can be observed. However, for the most part, these phenomena reflect the peculiarities of the course of the infectious process itself, and not just the febrile reaction.

The pulse rate during fever is directly related to the level of high temperature only in benign fevers caused by low-toxic pyrogens. This does not happen with all infectious diseases. For example, typhoid fever is characterized by a pronounced decrease in heart rate against the background of severe fever. In such cases, the effect of high temperature on frequency heart rate weakened by the influence of others causal factors and mechanisms of disease development. The respiratory rate also increases with the development of high fever. At the same time, breathing becomes more shallow. However, the severity of decreased breathing does not always correspond to the level of high temperature and is subject to significant fluctuations.

During the febrile period, the function of the digestive tract is always impaired in patients. Usually there is a complete absence of appetite, which is associated with decreased digestion and absorption of food. The tongue becomes coated various shades(usually white), patients complain of dry mouth.

The volume of secretions from the digestive glands (salivary, gastric, pancreas, etc.) is significantly reduced. Motor dysfunction gastrointestinal tract are expressed in various types of violations motor functions, usually with a predominance of spastic phenomena. As a result, the movement of intestinal contents slows down significantly, as does the release of bile, the concentration of which increases.

There are no noticeable changes in kidney activity during fever. An increase in daily urination in the first stage (an increase in temperature) depends on an increase in blood flow in the kidneys due to the redistribution of blood in the tissues. On the contrary, a slight decrease in urination with increased urine concentration at the height of the febrile reaction is explained by fluid retention.

One of essential components The protective-adaptive mechanism of fever is an increase in the phagocytic activity of leukocytes and tissue macrophages, and, what is especially important, there is an increase in the intensity of antibody production. Activation of cellular and humoral mechanisms immunity allows the body to adequately respond to the introduction of foreign agents and stop infectious inflammation.

High temperature itself can create unfavorable conditions for the proliferation of various pathogens and viruses. In light of the above, the purpose of developing a feverish reaction developed during evolution is clear. That is why fever is a nonspecific symptom of a large number of different infectious diseases.

Diagnosis and differential diagnosis of fever:

The duration of the febrile period allows us to divide all such conditions into short-term (acute) and long-term (chronic). The former include high fever lasting no more than two weeks, the latter - more than two weeks.

Acute fevers lasting no more than one week most often arise due to various viral infections upper respiratory tract and stop on their own without outside intervention. A number of short-term bacterial infections also cause acute fever. Most often they affect the pharynx, larynx, middle ear, bronchi, and genitourinary system.

If the fever persists for a longer period, then even with the apparent clarity of the clinical picture, the patient requires a more thorough examination. If prolonged fever is not consistent with other clinical manifestations or the general condition of the patient, the term “fever” is usually used. unknown etiology"(LNE).

The following febrile conditions are distinguished:
A. Acute:
I. Viral.
II. Bacterial.
B. Chronic:
I. Infectious:
viral ( Infectious mononucleosis, viral hepatitis B, cytomegalovirus infection, HIV);
bacterial (tuberculosis, brucellosis, septic endocarditis, etc.);
in persons with secondary immunodeficiency.
II. Tumor.
III. For systemic connective tissue diseases.
IV. For other conditions and diseases (endocrine, allergic, increased sensitivity threshold of the thermoregulation center).

Diseases and illnesses, causes of fever:

Non-infectious causes prolonged fever occur in no more than one third of cases. These include fever in subacute septic endocarditis, which is quite difficult to diagnose in the initial absence of a heart murmur. In addition, blood cultures do not detect the presence of bacteria in the blood in 15% of cases. Often there are no peripheral signs of the disease (enlarged spleen, Osler's nodes, etc.).

For purulent infection:

About 20-40% of fevers of unknown etiology (with an unknown cause) can be caused by systemic pathology of connective tissue (systemic lupus erythematosus, systemic scleroderma, rheumatoid polyarthritis, Sjögren's disease, etc.). Among other causes, the most important are tumor processes. Among the latter, a special place is occupied by tumors originating from the hematopoietic system (leukemia, lymphogranulomatosis, etc.). In some cases, fever may be due to the addition of an infection, as, for example, with bronchial carcinoma, when obstruction (difficulty breathing) and pneumonia of the underlying part of the lung develops.

For pathology of the endocrine system:

IN mandatory minimum laboratory tests of long-term febrile patients include general analysis blood with leukocyte count, determination of malarial plasmodia in a smear, tests functional state liver, bacteriological cultures of urine, feces and blood up to 3-6 times. In addition, it is necessary to carry out the Wasserman reaction, tuberculin and streptokinase tests, serological test for HIV, as well as X-ray examination lungs and ultrasound of the abdominal organs.

Even the presence of minor complaints of moderate headache, mild changes in mental status require a puncture of the cerebrospinal fluid with its subsequent examination. In the future, if the diagnosis continues to remain unclear, focusing on the results initial examination, the patient should determine the presence of such signs as antinuclear antibodies, rheumatoid factor, antibodies to Brucella, Salmonella, Toxoplasma, Histoplasma, Epstein-Barr virus, cytomegaly, etc., and also conduct a study for fungal diseases(candidiasis, aspergillosis, trichophytosis).

The next stage of examination in case of an unknown diagnosis in a long-term febrile patient is to carry out computed tomography, which allows you to localize tumor changes or abscesses of internal organs, as well as intravenous pyelography, puncture and culture bone marrow, endoscopy of the gastrointestinal tract.

If the cause of prolonged fever cannot be determined, it is recommended that such patients be given a trial of treatment, usually antibiotic therapy or specific anti-tuberculosis drugs. If the patient is already receiving treatment, it should be discontinued for a while to exclude the medicinal nature of the fever.

Drug fever:

Fever due to tumors:

In addition to staphylococcus, streptococcus and anaerobes, pathogens in inpatients with immunodeficiency can be fungi of the genus Candida and Aspergillus, pneumocystis, toxoplasma, listeria, legionella, cytomegalovirus and herpes viruses. Evaluation of such patients should begin with bacteriological research cultures of blood, urine, feces and sputum, as well as cerebrospinal fluid (depending on the clinical manifestations of the infection).

It is often necessary to start antibiotic therapy before results are obtained bacteriological culture. In such cases, one should focus on the most characteristic nature of the pathogen for a given localization of infection in the patient (streptococci and E. coli, as well as anaerobes for enterocolitis, E. coli and Proteus for urinary tract infections).

To recognize the causes of acute fevers, the nature of the temperature rise, its frequency and height, as well as its duration are of utmost importance. different periods fever. Various durations period of increased temperature may be a characteristic sign of a number of acute infectious processes. For example, for brucellosis and typhoid fever, a gradual increase in the temperature curve over several days to a maximum is typical.

Influenza, typhus, measles and most viral diseases of the respiratory tract are characterized by a short - no more than a day - period of temperature rise to high numbers. The most acute onset of the disease, when the temperature reaches its maximum within a few hours, is typical for meningococcal infection, relapsing fever, malaria. IN differential diagnosis The causes of febrile conditions should be based not only on one symptom (fever), but on the entire symptom complex of features of the course of a period of high temperature.

Rickettsial infections are typically characterized by a combination of acute development of fever with persistent headache and insomnia, as well as facial redness and motor agitation of the patient. The appearance of a typical rash on the 4th-5th day of the disease makes it possible to diagnose the clinical picture of typhus.

For typhus:

This is observed at the height of the disease. On the 8-10th day of illness, patients with typhus may also experience an “incision” in the temperature curve, similar to the first. But then after 3-4 days the temperature drops to normal. Typical febrile reactions are rare when antibiotic therapy is used. With uncomplicated typhus, the fever usually lasts 2-3 days, less often - 4 days or more.

Borelliosis (recurrent louse and tick-borne typhus) are characterized by a rapid rise in temperature to high numbers, accompanied by severe symptoms of intoxication and stunning chills. For 5-7 days, the high temperature remains at the achieved level, after which it critically drops to normal numbers, and then after 7-8 days the cycle repeats.

For typhoid fever:

For leptospirosis:

For malaria:

For erysipelas also characterized by an acute onset and the absence of a preceding period. The temperature rise reaches 39-40°C and may be accompanied by vomiting and agitation. Usually, pain and burning immediately occur in the affected area of ​​the skin, which soon becomes bright red in color with a ridge that sharply limits the area of ​​inflammation.

For meningitis:

With meningococcal infection, body temperature can range from slightly elevated to very high (up to 42°C). The temperature curve can be of a constant, intermittent and remitting type. During antibiotic therapy, the temperature decreases by the 2-3rd day; in some patients, a slightly elevated temperature remains for another 1-2 days.

Meningococcemia (meningococcal sepsis) begins acutely and proceeds rapidly. A characteristic feature is a hemorrhagic rash in the form of stars of irregular shape. Elements of the rash in the same patient can be of different sizes - from small pinpoints to extensive hemorrhages. The rash appears 5-15 hours after the onset of the disease. Fever with meningococcemia is often intermittent. Characteristics: pronounced symptoms of intoxication, temperature rises to 40-41°C, severe chills, headache, hemorrhagic rash, increased heart rate, shortness of breath, cyanosis. Then blood pressure drops sharply. Body temperature drops to normal or slightly elevated levels. Motor excitement increases, convulsions appear. And in the absence of appropriate treatment, death occurs.

Meningitis may not only be of meningococcal origin. Meningitis, like encephalitis (inflammation of the brain), develops as a complication of any previous infection. Thus, the most harmless, at first glance, viral infections, such as influenza, chicken pox, rubella, can be complicated by severe encephalitis. There is usually a high body temperature, sharp deterioration general condition, cerebral disorders, headache, dizziness, nausea, vomiting, impaired consciousness, and general anxiety appear. Depending on the damage to a particular part of the brain, various symptoms may be detected - disorders of the cranial nerves, paralysis.

Hemorrhagic fevers:

Fever due to influenza:

Fever with measles in adults:

The headache is moderate, and excessive sweating (or heavy sweats) is typical. There is an increase in all groups of lymph nodes, an enlargement of the liver and spleen. The disease usually begins gradually, less often acutely. Fever in the same patient can be different. Sometimes the disease is accompanied by a wave-like temperature curve typical for brucellosis of a remitting type, when fluctuations between morning and evening temperatures are more than 1 ° C, intermittent - a decrease in temperature from high to normal, or constant - fluctuations between morning and evening temperatures do not exceed 1 ° C.

Feverish waves are accompanied by profuse sweating. The number of waves of fever, their duration and intensity are different. The intervals between waves range from 3-5 days to several weeks and months. Fever can be high, low-grade for a long time, or it can be normal. The disease most often occurs with long-term low-grade fever. Characteristic is the replacement of a long febrile period with a fever-free interval, also of varying duration. Despite the high temperature, the condition of the patients remains satisfactory. With brucellosis, damage is noted various organs and systems, the musculoskeletal, urogenital (genitourinary), nervous systems are primarily affected, the liver and spleen are enlarged.

For yersinosis:

For infectious mononucleosis:

Fever due to polio:

For psittacosis:

Fever due to tuberculosis:

For sepsis:

An increase in body temperature can be observed with various diseases of the lungs, heart, and other organs. So, inflammation of the bronchi ( acute bronchitis) can occur during acute infectious diseases (influenza, measles, whooping cough, etc.) and when the body cools. Body temperature in acute focal bronchitis can be slightly elevated or normal, and in severe cases it can rise to 38-39°C. Weakness, sweating, and cough are also concerning.

The development of focal pneumonia (pneumonia) is associated with the transition inflammatory process from bronchi to lung tissue. They can be of bacterial, viral, fungal origin. Most characteristic symptoms focal pneumonia are cough, fever and shortness of breath. Fever in patients with bronchopneumonia varies in duration. The temperature curve is often of a laxative type (daily temperature fluctuations of 1°C, with the morning minimum above 38°C) or of an irregular type. Often the temperature is slightly elevated, and in the elderly and old age may be absent altogether.

Lobar pneumonia is more often observed when the body is hypothermic. Lobar pneumonia is characterized by a certain cyclical course. The disease begins acutely, with tremendous chills and an increase in body temperature to 39-40°C. Chills usually last up to 1-3 hours. The condition is very serious. Shortness of breath and cyanosis are noted. At the height of the disease, the condition of patients worsens even more. Symptoms of intoxication are pronounced, breathing is frequent, shallow, tachycardia up to 100/200 beats/min.

Against the background of severe intoxication, vascular collapse may develop, which is characterized by a drop in blood pressure, increased heart rate, and shortness of breath. Body temperature also drops sharply. The nervous system suffers (sleep is disturbed, there may be hallucinations, delusions). With lobar pneumonia, if antibiotic treatment is not started, the fever can last for 9-11 days and be permanent. The temperature drop can occur critically (within 12-24 hours) or gradually over 2-3 days. During the resolution stage, there is usually no fever. Body temperature returns to normal.

For rheumatism:

The temperature curve is remitting in nature, accompanied by weakness and sweating. After a few days, joint pain appears. Rheumatism is characterized by damage to the heart muscle with the development of myocarditis. The patient is concerned about shortness of breath, pain in the heart area, and palpitations. There may be a slight increase in body temperature. The febrile period depends on the severity of the disease. Myocarditis can also develop with other infections - scarlet fever, diphtheria, picquetheiasis, viral infections. Allergic myocarditis may occur, for example, when using various medications.

For endocarditis:

Diagnosis of primary bacterial endocarditis is particularly difficult, since at the onset of the disease there is no damage to the valve apparatus, and the only manifestation of the disease is fever of the wrong type, accompanied by chills, followed by profuse sweating and a decrease in temperature. Sometimes a rise in temperature may occur during the day or at night. Bacterial endocarditis can develop in patients with artificial valves hearts. In some cases, there are fevers caused by the development of a septic process in patients with catheters in the subclavian veins, which are used in infusion therapy.

In case of damage to the biliary system:

For kidney disease:

For tumor diseases:

Often, fever is the only symptom of a malignant disease. Feverish conditions often occur with malignant tumors of the liver, stomach, intestines, lungs, and prostate gland. There are cases where fever for a long time was the only symptom of malignant lymphoma localized in the retroperitoneal lymph nodes. The main causes of fever in cancer patients are considered to be the accession infectious complications, tumor growth and the effect of tumor tissue on the body. The third place in the frequency of febrile conditions is occupied by systemic diseases connective tissue (collagenosis). This group includes systemic lupus erythematosus, scleroderma, arteritis nodosa, dermatomyositis, rheumatoid arthritis.

Systemic lupus erythematosus is characterized by a steady progression of the process, sometimes with rather long remissions. In the acute period there is always a fever of the wrong type, sometimes taking on a hectic character with chills and profuse sweat. Characterized by dystrophies, damage to the skin, joints, various organs and systems.

For systemic vasculitis:

Among patients with prolonged fever, drug fever occurs in 5-7% of cases. It can occur on any medications, often on the 7-9th day of treatment. Diagnosis is facilitated by the absence of an infectious or somatic disease, the appearance of a papular rash on the skin, coinciding with the time of taking medications. This fever is characterized by one feature: the symptoms of the underlying disease disappear during therapy, and the body temperature rises. After discontinuation of the drug, body temperature usually normalizes within 2-3 days.

For endocrine diseases:

Thermoregulation disorder is manifested by an almost constant feeling of heat, intolerance to heat, thermal procedures, and slightly elevated body temperature. An increase in temperature to high numbers (up to 40°C and above) is typical for complications of diffuse toxic goiter- thyrotoxic crisis, which occurs in patients with severe forms of the disease. All symptoms of thyrotoxicosis sharply worsen. A pronounced excitement appears, reaching the point of psychosis, the pulse quickens to 150-200 beats/min. The skin of the face is red, hot, moist, the limbs are cyanotic. Are developing muscle weakness, trembling of the limbs, pronounced paralysis and paresis.

Acute purulent thyroiditis - purulent inflammation thyroid gland. It can be caused by various bacteria - staphylococcus, streptococcus, pneumococcus, E. coli. It occurs as a complication of purulent infection, pneumonia, scarlet fever, abscesses. The clinical picture is characterized by an acute onset, an increase in body temperature to 39-40°C, chills, rapid heartbeat, severe pain in the neck, shifting to lower jaw, ears, worse when swallowing, moving the head. The skin over the enlarged and sharply painful thyroid gland is red. The duration of the disease is 1.5-2 months.

For polyneuritis:

With allergic polyneuritis that develops after administration of the rabies vaccine (used to prevent rabies), an increase in body temperature may also be observed. Within 3-6 days after administration, high body temperature, uncontrollable vomiting, headache, and confusion may occur. There are constitutionally determined hypothalamopathies (“habitual fever”). This fever has a hereditary predisposition and is more common in women. young. Against the background of vegetative-vascular dystonia and constant low-grade fever, an increase in body temperature to 38-38.5°C is noted. A rise in temperature is associated with physical activity or emotional stress.

For artificial fever:

The diagnosis of “artificial fever” can be suspected only after observing the patient, examining him and excluding other causes and diseases that cause an increase in body temperature. Fever can occur with various acute surgical diseases(appendicitis, peritonitis, osteomyelitis, etc.) and is associated with the penetration of microbes and their toxins into the body. A significant increase in temperature in the postoperative period may be due to the body's reaction to surgical trauma.

When muscles and tissues are injured, the temperature may rise as a result of the breakdown of muscle proteins and the formation of autoantibodies. Mechanical irritation of thermoregulation centers (fracture of the base of the skull) is often accompanied by an increase in temperature. At intracranial hemorrhages(in newborns), post-encephalitic brain lesions also have a high temperature, mainly as a result of a central disturbance of thermoregulation.

For acute appendicitis:

When the appendiceal inflammatory seal suppurates, a periappendiceal abscess is formed. The condition of the patients is deteriorating. Body temperature becomes high and hectic. Sudden changes in temperature are accompanied by chills. Abdominal pain gets worse. A serious complication of acute appendicitis is diffuse purulent peritonitis. Abdominal pain is diffuse. The condition of the patients is serious. There is a significant increase in heart rate, and the pulse rate does not correspond to body temperature. Brain injuries can be open (with damage to the bones of the skull and brain matter) and closed. TO closed injuries include concussion, bruise and concussion with compression.

For a concussion:

With sunstroke and heatstroke, general overheating of the body is not necessary. Violation of thermoregulation occurs due to exposure to direct sun rays on an uncovered head or naked body. Weakness, dizziness, headache, nausea are a concern, and sometimes vomiting and diarrhea may occur. In severe cases, agitation, delirium, convulsions, and loss of consciousness are possible. As a rule, there is no high temperature.

Treatment of fever:

Physical means include methods that provide cooling of the body: it is recommended to remove clothes, wipe the skin with water, alcohol, 3% vinegar solution, or apply ice to the head. You can apply a bandage moistened to your wrists and head. cold water. Gastric lavage through a tube with cold water (temperature 4-5°C) is also used, and cleansing enemas are given, also with cool water. In the case of infusion therapy, all solutions are administered intravenously cooled to 4°C. The patient can be blown with a fan to reduce body temperature. These measures allow you to reduce body temperature by 1-2°C within 15-20 minutes. You should not lower your body temperature below 37.5°C, as after this it continues to decrease on its own.

As medications analgin is used, acetylsalicylic acid, Brufen. It is most effective to use the drug intramuscularly. So, use a 50% solution of analgin, 2.0 ml (for children - at a dose of 0.1 ml per year of life) in combination with antihistamines: 1% solution of diphenhydramine, 2.5% solution of pipolfen or 2 % solution of suprastin. To reduce body temperature and reduce anxiety, a 0.05% solution of chlorpromazine can be used orally. Children under 1 year old - 1 tsp., from 1 year to 5 years old - 1 tsp. l., 1-3 times a day. To prepare a 0.05% solution of chlorpromazine, take an ampoule of a 2.5% solution of chlorpromazine and dilute the 2 ml contained in it with 50 ml of water.

With more in serious condition to reduce the excitability of the central nervous system, lytic mixtures are used, which include aminazine in combination with antihistamines and novocaine (1 ml of a 2.5% solution of aminazine, 1 ml of a 2.5% solution of pipolfen, 0.5% - nal solution of novocaine). Single dose formula for children is 0.1-0.15 ml/kg body weight, intramuscularly.

To maintain adrenal function and lower blood pressure, corticosteroids are used - hydrocortisone (for children 3-5 mg per 1 kg of body weight) or prednisolone (1-2 mg per 1 kg of body weight). In the presence of respiratory disorders and heart failure, therapy should be aimed at eliminating these syndromes. When body temperature rises to high levels, children may develop convulsive syndrome, to stop which Seduxen is used (children under 1 year at a dose of 0.05-0.1 ml; 1-5 years - 0.15-0.5 ml of a 0.5% solution, intramuscularly).

To combat cerebral edema, use magnesium sulfate 25% solution in a dose of 1 ml per year of life intramuscularly. First aid for heat and sunstroke is as follows. It is necessary to immediately stop exposure to the factors that led to sunstroke or heatstroke. It is necessary to move the victim to a cool place, remove clothes, lay him down, and raise his head. Cool the body and head by applying compresses with cold water or dousing with cold water.

The victim is given a sniff ammonia, inside - soothing and cardiac drops (Zelenin drops, valerian, Corvalol). The patient is given plenty of cool fluids. If respiratory and cardiac activity stops, it is necessary to immediately release the upper Airways from vomit and start artificial respiration and cardiac massage until the first respiratory movements and cardiac activity appear (determined by pulse). The patient is urgently hospitalized in a hospital.