I had this 14 years old boy who was brought into ED by his father around 2am complaining about fever. He was seen in local clinic and discharged with antipyretics (TID dose). He had taken his last antipyretic more than 8 hrs ago. I examined the patient and the preliminary diagnosis was influenza as he had most of the cardinal sign.
I offered a suppository voltaren and explained that it was the dosing interval that cause the fever to recurred. The father after hearing my explanation had ask me, “Is that it ?”. Well, since he wanted to go further, I had told me that – why not an IV , the child is really dehydrated. But still the father repeat the question, “is that is?”. Some irritation but I knew what he wants – he wants an injection – no way of giving any aspergic…. Ketoprofen ? IM is to painful for a child, not my style of punishing a rude father by hurting his child…. So here come the guerrilla tactics of mine – I offered him a influenza rapid test… few months ago, the department of health had stopped providing free rapid test- patient have to pay for it…. NT400 it is… When I told the father – he show a queer look after knowing the NT400 charge… After pausing a moment, he had agreed with the test and I saw his disturbance and forget about the injection...
The test had come back positive of B 30 mins later, I informed the father and discussed about the use of Tamiflu with him. I strongly advised him not to use it and he concurred with my suggestion. I had put the child on a adequate dose of parecetamol with proper dosing. Prn Mefenamec acid was prescribed as I knew it would be difficult to suppress the fever.
Well, sometimes you would need to treat the family; confronting them would only increase their disbelief and only to show that you care the patient more than he does, you have their trust to treat the needed…..so much for the guerrilla tactics…
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