Rigors - Treatment

Authored by Dr Mary Lowth, 30 May 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Prof Cathy Jackson, 30 May 2017

The most important thing is to work out what is causing the rigor and then to treat that cause. However, whilst the rigor is happening there are a few things you can do to make the person who is experiencing it more comfortable, calm and reassured.

  • Give lots to drink. This helps to prevent a lack of fluid in the body (dehydration). You might find that a child is more willing to have a drink if they are not so irritable. It may help to give some paracetamol and then try again with drinks half an hour or so later.
  • Tepid sponging is not recommended because the blood vessels under the skin become narrower (constrict) if the water is too cold, which actually reduces heat loss. People with rigors find sponging uncomfortable in the shivery phase.
  • Cold fans are not recommended, for the same reasons, although cooling an over-warm room with adequate ventilation is sensible.
  • Children with high temperature (fever) should not be underdressed or over-wrapped.
  • Medicines like paracetamol and ibuprofen should not be used for fever unless your child appears distressed:
    • Using paracetamol and ibuprofen does not prevent febrile convulsions.
    • You can use either paracetamol or ibuprofen in children with fever who appear distressed.
    • You should not use both at the same time. Paracetamol is usually recommended as the first option.

See separate leaflet called Fever/High Temperature in Children for more information on managing fever

Remember that paracetamol and ibuprofen do not treat the cause of the rigor. It is still important to seek medical advice to discover what caused the rigor, so that the correct treatment can be begun.

This is likely to require advice from a healthcare professional.

If the cause of the rigor is a viral infection then once a healthcare professional has identified this, it's possible that there will be no specific treatment, but you will be given information about what to expect from the condition. Some viral infections, such as measles, can be serious, and your child may need to stay in hospital if they are unwell.

Sometimes 'empirical' treatments are used. This means that the doctors are not yet certain of the cause of the rigors but they treat the patient with a broad-spectrum antibiotic. This is often given intravenously, as this is fastest and most effective in serious illness. The antibiotic or antibiotics chosen will be those effective against the most likely cause of the rigors. In malarial zones (where malaria would be a highly likely cause of an unexplained temperature), malaria treatments may also be started before there is a firm diagnosis.

It is also likely that an intravenous drip will be set up. This allows you to be given extra fluid but also provides a useful route for giving intravenous antibiotics.

You may experience a rigor again the next time you have an infection that causes a high temperature (fever). The chance of reacting in this way to infection decreases slowly as you become older.

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