A Comparison of Three Methods of Managing Fever in the Neurologic Patient

Patients with neurological dysfunction can suffer fevers due to irritation of, or damage to the temperature-regulating center in the brain, or a combination of both. Although hypothermic therapy is a critical treatment nurses often perform, the most effective cooling method has not been studied in the neurological patient. The purpose of this quasi-experimental study was to compare the effectiveness of three methods of fever reduction, and the effect of each on patient shivering. Twenty-one adult febrile neurological patients were randomly placed in one of three temperature reduction groups. One of the temperature reduction protocols was initiated when a subject first became febrile. Rectal temperatures were taken every 15 minutes using an IVAC Temp-Plus thermometer until the subject's temperature returned to 100 degrees F. Subjects were observed for shivering throughout the procedures. The mean time necessary for the subject's temperature to return to 100 degrees F was calculated. A one-way analysis of variance of the time required to reach 100 degrees F was done to determine if a significant difference existed in rate of temperature reduction among the groups. The analysis revealed no statistically significant difference among the three methods, but a chi-square analysis indicated a significant relationship between shivering and the use of a hypothermia blanket.