Febrile seizures
What heart rate in a child can be d/t sepsis?
180 bpm
At what point in illness does febrile seizure occur?
1st day, can be first manifestation
MC age for febrile seizures
6m to 5y MC 12-18 mos
What temperature of fever does seizure occur at in most cases?
>39 C
Vaccination that has small risk of causing seizure the day of
DTap, IBV, HIB combination
MC viral infection causing febrile seizures
HHV-6
Meningeal s/sx 6-12 m old without HIB or pneumo vax patient already on abx late febrile seizure of status epilepticus what should be done?
LP
Vaccination that has risk of seizures 1-2 weeks after especially when given at an older age
MMR
What diseases should be considered in complex febrile seizure in <12 month old?
bacterial meningitis structural disease metabolic disease
Developmental delays are associated with this type of febrile seizure
complex
Focal seizure with loss of consciousness lasting over 15 minutes
complex febrile seizures
Home therapy for recurrent prolonged febrile seizure
diazepam rectal or midazolam nasal
Treatment of febrile seizure if >5 minutes
diazepam, lorazepam, midazolam
What happens when a seizure ends?
eyes close, deep breath, normal breathing
>30 minutes of continuous or intermittent seizures
febrile status epilepticus
What iron level is associated with febrile seizures
ferritin <30
Treatment of febrile seizure doesn't respond to BZD or febrile status epilepticus
fosphenytoin IV multiple meds
What is determinent of febrile seizures - height of fever or rate?
height of fever
What should you tell parents of a pt with simple febrile seizure about future epilepsy risk?
it's very very low - only 1-2% vs 1%
Are there found to be differences in deficits, intellectual outcomes and behavior in children with febrile seizures?
no
Do antipyretics have a role in recurrent prolonged febrile seizure?
no
Young age at first febrile seizure, 1st degree relative w febrile seizures, fever low at seizure, brief time between fever and seizure indicate risk for this
recurrence
What needs to be monitored if midazolam is administered?
respiratory and circulatory status
Tonic clonic MC in this type of febrile seizure
simple
Which type of febrile seizure is more common
simple
Generalized seizure with no LOC lasting under 15 min
simple febrile seizure
What seizure can you educate patient and d/c home?
simple febrile seizure
What is at an increased risk in children with complex febrile seizures
sudden death
Treatment of febrile seizure if it's stopped by the time child is in ED
treat fever