16 International Journal of Nursing Care. January-June., 2013, Vol.1, No.

Warm Sponging Versus Tepid Sponging in Febrile

Children: Double Blind Randomized Controlled Trial of
efficacy

Athirarani M R
Assistant Professor, Govt. College of Nursing, Thiruvananthapuram, Kerala

ABSTRACT
Objective: To compare the efficacy of Warm Sponging with Tepid Sponging among children aged 6
months to 5 years with fever (>100oF to <104oF) and receiving syrup Paracetamol 15mg/kg body weight
in reducing body temperature by at least 20F or to normal temperature (98.6oF) at 30 minutes of
initiation of sponging
Materials and Method: The design adopted for the study was Parallel Group Double Blind Randomized
Controlled Trial
The participants consisted of 268 Children aged 6 months to 5 years of age and axillary temperature
100oF to 104oF were recruited from out patient department of a primary care setting and were screened
by review of medical history. Exclusion criteria were history of seizures, intake of antipyretics within 6
hrs, contraindications to paracetamol , dehydration and disorders of central nervous system. There
were two arms for the study i.e the Experimental group received Warm Sponging & paracetamol
(n=134) and Control group ;Tepid sponging & paracetamol, (n=134). The Outcome measure was
reduction of body temperature by at least 2oF or attaining normal temperature (98.6o F).
Results: There was a statistically significant difference in proportion of target temperature reduction
between Warm sponging and Tepid sponging groups . Chi square 21.145 at 1d(f) , P value 0.00001: The
achievement of target temperature in Warm sponging group was 49.25% and 22.39% in Tepid sponging
group, the difference in proportion between group is 26.86% ( 95% CI of 15.84% - 37.88%).
Conclusion: The study concluded that warm sponging along with oral paracetamol, was found to be
more effective than tepid sponging along with oral paracetamol in reducing temperature in febrile
children.

Keywords: Febrile Children, Paracetamol, Tepid Sponging, Warm Sponging

INTRODUCTION However, the efficacy of externally applied cooling

Fever is the commonest symptom of disease in
children(1). According to National Family Health
Survey III (2005-06), in India, 15 percent of children
under age three were ill with fever in the two weeks
prior to survey and among this 71% of children with
fever were taken to a health facility or to a provider(2) ..
Under normal circumstances, human body maintains
a normal range of internal body temperature that is
called the “set point”. It is not a specific temperature
but is a range of temperature (approximately 36.200 to
37.800C) above or below which compensatory warming
or cooling mechanisms are activated(3). The efficacy of
paracetamol as an antipyretic acting at the
hypothalamic set point is already established (4) .
measures for reducing fever has not been established(5)
Regarding external cooling measures, there are different
opinions about the use of sponging as an intervention.
The use of tepid sponging for reduction of fever has
been in practice for a long time. Recently it has been
claimed that warm sponging is better than tepid
sponging and that it has more physiological basis than
tepid sponging as a treatment for fever (6 ) (7) (8) . Globally
no study has been conducted to test the efficacy of warm
sponging compared to tepid sponging. Cochrane
Library on systematic review also recommends that it
would be helpful to compare warm sponging with tepid
sponging, with paracetamol in both arms, in a
randomized study (9)(10).

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