Febrile Seizures in Emergency Medicine Treatment & Management

  • Author: Nooruddin R Tejani, MD; Chief Editor: Richard G Bachur, MD   more...
 
Updated: Aug 31, 2011
 

Prehospital Care

  • Patients with active seizures should be treated with airway management, high-flow oxygen, supportive care, and anticonvulsants as necessary. Acute treatment such as rectal diazepam (0.5 mg/kg) and buccal 0.4-0.5 mg/kg) or intranasal (0.2 mg/kg) are effective and can be given at home for a seizure lasting longer than 5 minutes.[29, 30, 31]
  • Patients who are postictal should receive supportive care and antipyretics as appropriate.
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Emergency Department Care

  • Patients presenting with status epilepticus should be treated with airway management and anticonvulsants as necessary.
  • Patients presenting with history and physical examination findings consistent with a simple febrile seizure should have frequent neurologic examinations to monitor mental status.
  • Other causes of seizure should be ruled out.
  • The cause of the febrile illness should be sought and treated.
  • Antipyretics should be considered. Acetaminophen (Tylenol) and ibuprofen (Motrin) are often used.
  • Parental anxiety and fear that their child may die or will develop brain damage needs to be addressed with reassurance and education.
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Contributor Information and Disclosures
Author

Nooruddin R Tejani, MD  Assistant Professor, Department of Emergency Medicine, SUNY Health Sciences Center Brooklyn; Director, Pediatric Emergency Medicine, Downstate Medical Center

Nooruddin R Tejani, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Debra Slapper, MD  Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital

Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Wayne Wolfram, MD, MPH  Associate Professor, Department of Emergency Medicine, Mercy St Vincent Medical Center

Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Richard G Bachur, MD  Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston

Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, William T Zempsky, MD, to the development and writing of this article.

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