Customer scenario
Customer scenario
Martha’s granddaughter Sara has a mild fever. Sara is chewing on a cool teething ring and looks unsettled. Martha wants something to help relieve Sara’s teething pain.
Using the WWHAM framework, you establish:
The medicine is for Sara, a 6-month-old baby who weighs approximately 7kg
Apart from teething pain and a mild fever, her gums are red and inflamed
She has been suffering for the past week
She has not tried any medication yet, only self-care methods (including the teething ring)
Sara doesn’t take any regular medication and does not have any medical conditions
With the information that you have, and using your knowledge of the guidance, what would you recommend at this stage?
Offer paracetamol OR ibuprofen suspension to provide symptom relief as self-care measures alone have not helped
Correct!
Offer both paracetamol AND ibuprofen to be used alternatively throughout the day to relieve Sara’s symptoms
Incorrect! Try again
Advise Martha to take Sara to the GP for further assessment as her pain is unlikely to be managed with OTC treatment
Incorrect! Try again
Using your knowledge of how paracetamol and ibuprofen work, including their respective benefits, and considering Sara has inflamed, swollen gums, which of the two products would you recommend?
Try again!
Although paracetamol can help to manage teething pain and the associated mild fever, it has no anti-inflammatory properties. Ibuprofen may be better suited to relieve Sara’s painful, red gums.
Correct!
While paracetamol is also effective, ibuprofen can help to reduce Sara’s fever, relieve her teething pain and, because it is an anti-inflammatory, it may help to relieve swelling and redness around the gums too.
Martha returns a few days later as Sara is still suffering and not sleeping well. Martha stopped giving ibuprofen and swapped to CALPOL Infant Suspension (paracetamol) that she had at home. Although Sara no longer has a fever, her pain still does not seem to be managed fully.
Martha is wondering if she can give both ibuprofen and paracetamol at the same time as she often takes them together herself when she is in pain, which helps.
What advice can you give Martha?
Select all the options you think would be appropriate:
Unlike adults, ibuprofen and paracetamol should not be administered at the same time when treating children
Ibuprofen and paracetamol doses can be alternated throughout the day leaving 1-3 hour intervals between each dose
Remind her to not exceed the maximum dose of each drug in a 24-hour period and to read the dosage instructions carefully (paracetamol is usually given every 4-6 hours and ibuprofen every 6-8 hours)
Keep a treatment diary as a reminder of which drug has been given and when; you can help her to create a rough timeline
Offer a teething gel such as CALGEL which contains a mild anaesthetic and antiseptic that can be used alongside the pain relief, if required
She should not give Sara either paracetamol or ibuprofen and she should take her to the GP for urgent assessment
Martha is very grateful for your advice and support as she is currently the sole caregiver for Sara and she has been very overwhelmed and concerned. Remind Martha that it is important that she looks after herself too and reassure her that she can come back if she has any further questions.
CALPOL® has a range of products for everyday childhood symptoms. To learn about the full range click below
References
1. NICE. How do analgesics work? 2021.
Available at: https://cks.nice.org.uk/topics/analgesia-mild-to-moderate-pain/background-information/mode-of-action
2. MedlinePlus. Acetaminophen. 2023. Available online at: https://medlineplus.gov/druginfo/meds/a681004.html
3. MedlinePlus. Ibuprofen. 2023. Available online at: https://medlineplus.gov/druginfo/meds/a682159.html
4. SmPC. Calpol Sugar Free Infant Suspension. 2022. Available at: https://www.medicines.org.uk/emc/product/256/smpc
5. SmPC. Calprofen 100mg/5ml oral suspension ibuprofen. 2024. Available at: https://www.medicines.org.uk/emc/product/339/smpc
6. Pelen F, et al. Traitement de la fièvre en monothérapie, Ibuprofène suspension pédiatrique a 100 mg/5 ml étude multicentrique d'acceptabilité menée en milieu hospitalier. Annales de Pédiatrie. 1998; 45(10): 719-728.
7. NHS. About paracetamol for children. 2022.
Available online at: https://www.nhs.uk/medicines/paracetamol-for-children/about-paracetamol-for-children/
8. NHS. About ibuprofen for children. 2022.
Available online at: https://www.nhs.uk/medicines/ibuprofen-for-children/about-ibuprofen-for-children/
9. NICE. Analgesia-mild-to-moderate-pain. 2021.
Available online at: https://cks.nice.org.uk/topics/analgesia-mild-to-moderate-pain/management/choice-of-analgesic/
10. NHS. Taking paracetamol for children with other medicines and herbal supplements. 2022. Available at: https://www.nhs.uk/medicines/paracetamol-for-children/taking-paracetamol-for-children-with-other-medicines-and-herbal-supplements/
11. NHS. High temperature (fever) in children. 2024. Available at: https://www.nhs.uk/conditions/fever-in-children/
12. NHS. Looking after a sick child. 2021. Available online at: https://www.nhs.uk/conditions/baby/health/looking-after-a-sick-child/
Online references last accessed August 2024.
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