Strategies to raise and lower body temperature

Raising body temperature	Lowering body temperature
Add extra layers of thin clothing or bedding. Multiple layers of thin clothing are more effective than one or two thick layers, as they trap the warm air. Some man-made fibres can encourage sweating and thus may decrease temperature. Cotton is therefore preferable	Remove layers of clothing/bedding. Do not remove all at once or you may cause the client to shiver, which will have the overall effect of increasing rather than decreasing body temperature
Encourage the client to wear a hat or cover the head, as most heat is lost through the scalp	Encourage the client to wear natural cotton fibres as these absorb heat
If possible close any open windows and doors	Use a fan positioned on the client’s back as this forms a larger surface area
Give the client warm drinks if allowed	Give the client cold drinks if allowed or ice to suck
If possible increase the room temperature	If possible reduce the room temperature or place the client near an open window but not in a draught
Adults and older children can be helped or encouraged to wash their hands and face in warm water provided that they have full sensation. Otherwise there is a risk of burn injury. For this reason hot-water bottles and high-temperature heat pads are not recommended and are indeed banned in most institutions	Adults and older children can be helped or encouraged to wash their hands and face in tepid water. Tepid sponging of the whole body where the client is allowed to dry by the process of evaporation is not generally recommended as this can reduce the temperature too rapidly (see below)
Monitor the client’s temperature when actively intervening and ensure that it does not rise more rapidly than 1oC per hour as this can lead to shock. If the client requires their temperature restoring more quickly, this should be undertaken in a critical-care area where the client can be closely monitored	Monitor the client’s temperature when actively intervening and ensure in the case of adults that it does not fall more rapidly than 1oC per hour as this can lead to shock. In the case of infants high temperatures can cause febrile convulsions; it is therefore appropriate to reduce their temperature more rapidly. This can be achieved by immersing them fully in a cool water bath
If the client is seriously hypothermic (i.e. a temperature of 32.5oC or below) and continuously monitored a foil blanket may be used with caution, but again care should be taken to ensure that the body temperature does not increase too rapidly. Warmed intravenous fluids may also sometimes be prescribed for this client group but again great care is needed	An antipyretic such as paracetamol may be prescribed if other methods of temperature reduction have failed, though this should not be the action of first resort as it can interfere with the body’s natural defence mechanisms