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High fever and high blood pressure after accident - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2305 Questions
my wfe was in a car accident, hit from the rear. She has been diagnosed with whiplash. At the emergency room they notice a fever 99 degrees blood pressure was high. Since it has been between 100-102. She had xray on spine and catscan. Should we be worried about fever?                                                        
Doctor :   Hi
Doctor :
Doctor :   may i read your post
User :   Please
Doctor :   fever is an acute reaction to trauma
User :   It's been 34 hours
Doctor :   it happens wen the blood and its products get released in to body fast
Doctor :   as in trauma
Doctor :   then the other chance is SEPSIS
Doctor :   an infection that causes fever
Doctor :   is she diabetic?
User :   No
User :   No
Doctor :   ok
User :   No open wounds in accident
Doctor :   is she on antibiotics
Doctor :   is there anything wrong in xray and scan
Doctor :   ok
User :   No she just took vicodin 5 mg 500apap
Doctor :   it might be internal injuries sometimes
Doctor :   ok
Doctor :   whiplash is typically not a life threatening injury
Doctor :   but it can lead to a prolonged period of partial disability.
User :   They didn't say anything except inflammation
Doctor :   yes inflammation
Doctor :   is due to release of fever causing agents
Doctor :   called pyrogens
User :   Last night I noticed parts of her body were hot to the touch
Doctor :   is she having low bp anytime
Doctor :   ok
Doctor :   was blood culture done
Doctor :   to look for infection
Doctor :   if intestines or stomach
Doctor :   is injured
Doctor :   its contents spill
User :   No not when they Checked it three times always high
Doctor :   in abdomen
Doctor :   and causes fever
Doctor :   as a foreign body reaction
Doctor :   ok
Doctor :   when bp is low it means internal bleeding
User :   No didn't do blood culture
Doctor :   ok
Doctor :   any injury to internal organs detected?
Doctor :   in traumatic brain injury fever can come
Doctor :   In the presence of Trauamtic brain injury, fever may be associated with increased excitatory amino acid release, increased vasogenic edema, increased intracranial pressure, and increased metabolic expenditure, ultimately resulting in increased neuronal loss
User :   None detected by ct or xray but has occasion shooting pain on right abdomen and right pelvic area
Doctor :   Fever in the TBI patient may result from a number of sources including infection, drug reactions, deep vein thrombosis, or central nervous system-mediated as a result of the injury
Doctor :   ok
Doctor :   is she on anti fever medications
Doctor :   what about spine or brain injury ?
User :   No just vicodin
Doctor :   ok
Doctor :   The major management goal following TBI is prevention of further brain injury from secondary insults , such as fever, which are often preventable or treatable.
User :   That what I read which got me worried but her head didn't slam into anything because she saw it coming and braced
Doctor :   ok
Doctor :   was a scan of head taken
User :   Did a ct of neck
Doctor :   any cervical spinal injury
Doctor :   The most common symptoms related to whiplash include: * neck pain and stiffness,
* headache,
* shoulder pain and stiffness,
User :   Just typical whiplash
Doctor :   ok
User :   Yes she is experiencing all of those plus the fever and the abdominal pain
Doctor :   ok
Doctor :   Treatment of whiplash depends on the wide variety of symptoms present.
Doctor :   Often the initial treatment for whiplash has been a soft cervical collar
Doctor :   The goal of the collar is to reduce the range of motion of the neck and to prevent any additional injuries
Doctor :   Patients involved in early range of motion exercises have been shown to have a more reliable and rapid improvement in their symptoms.
Doctor :   Physical therapy can be useful in helping to wean a patient from a cervical collar as well as to help strengthen muscles and reduce painful motions.
Doctor :   In trauma patients, elevated body temperature is a common
Doctor :   A febrile response until day 4 after injury will not increase morbidity
Doctor :   was a CT MRI taken
User :   Ok so we should keep an eye on the fever, if it is one of the other things that are less common what would be something I need to look for
Doctor :   yes raised blood counts
Doctor :   blood culture positive for microbes
Doctor :   etc
Doctor :   elevated ESR
Doctor :   even in acute trauma some time these will be elevated for some time
User :   How do I check that; go to primary physician, go to clinic tomorrow
Doctor :   since she has no open wounds
Doctor :   she is safe
Doctor :   is she in hospital now?
User :   No home
Doctor :   ok
Doctor :   so when was the accident
User :   What is ESR
Doctor :   and when you went to home
Doctor :   esr is erythrocyte sedimentation rate
Doctor :   and blood sign of infection etc
User :   34 hours ago she was home 7 hours after the accident
Doctor :   Once discharged from hospital# Neck massage
# Neck rest
# Bed rest
# Ice therapy
# Heat therapy
# Oral pain relievers and muscle relaxers
Doctor :   are advised
Doctor :   If no serious injury is detected in the emergency department, then the patient will be allowed to return home
Doctor :   with advised follow up care
User :   They did not give her muscle rela
Doctor :   If you continue to have symptoms from your whiplash injury, contact the doctor.
Doctor :   is she doing some exercises
User :   xants but I have some should I give her one
Doctor :   or meeting a rehabilitation physician
Doctor :   if she has pain you may
User :   She was walking around a little today but I wouldn't let her do too much
Doctor :   ok
Doctor :   Recovery time depends on how serious your whiplash is. Most cases resolve in a few days. But other neck strains may take weeks or longer to heal. Remember that everyone heals at a different rate.
User :   I have cyclobenzaprines
Doctor :   Once the acute symptoms of neck strain are gone, your doctor will probably want you to start rehabilitation.
Doctor :   This will make your neck muscles stronger and more limber. It will help you both recover and reduce the odds of straining your neck again in the future.
Doctor :   ok
Doctor :   you may try some local gels or ointments too
User :   Ok have a product called botanogesic
User :   Have arnica as well
Doctor :   ok
Doctor :   try that
User :   Arnica AAAAAAA
User :   Topical and oral
Doctor :   botanogesic is topical salve
Doctor :   contains methyl salicylate
Doctor :   'try that
User :   I think it has capsacin to
Doctor :   and any single pain killer tablet too
Doctor :   yes
Doctor :   Methyl Salicylate (Oil of Wingergreen), Menthol, Eucalyptus oil
Doctor :   Ginger oil, Boswellia oleo-gum-resin (Boswellia serrata), Clove oil, Cinnamon leaf oil, Capsicum oleo-gum-resin in a vanishing cream base
Doctor :   etc i s there
Doctor :   try any one only
Doctor :   do take her for follow up soon
Doctor :   and also check out
Doctor :   with a local rehabilitation centre
Doctor :   to do muscle strengthening exercises
Doctor :   only after neck
Doctor :   pain
Doctor :   has subsided
Doctor :   If you start pushing yourself before your neck strain is healed, you could end up with chronic neck pain and permanent injury.
Doctor :   Thanks for consulting....
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