Febrile Seizure in Pediatrics

1. Febrile seizure

    1. >38-39 C

    2. in 6m/o to 60m/o

    3. presents as GTC

    4. only one time in 24 hours

    5. last less than 15 minutes

2. Check

    1. brain CT without contrast

    2. BUN, Cr

    3. Na, K, Mg, Ca, P

    4. BS

    5. Trauma Hx

    6. ECG for arrhythmias

    7. Hx of seizure or poisoning

3. Management

    1. LLP positioning

    2. open airways

    3. O2 therapy

    4. Amp Diazepam 0.5mg/kg rectal/nasal if needed up to 3 times

        1. or Amp diazepam 0.2mg/kg IV

        2. or Amp midazolam 0.2mg/kg nasal

    5. If not controlled:

        1. Amp Phenytoin 20mg/kg in N/S

            1. do not infuse in DW

        2. Amp phenobarbital 20mg/kg

        3. Drip Midazolam 0.05-0.2mg/kg/hr

4. do not use diazepam for infants

5. Discharge the pt with

    1. Syrup acetaminophen 120mg/5ml w/2cc qid

    2. Tab diazepam 0.3mg/kg tds for 2 days #20 (tab 2, 5, 10 mg)

        1. or syrup diazepam 2mg/5l

        2. or supp diazepam 5mg

6. prognosis:

    1. if there is no risk factor: 10% chance of seizure

7.