Here is Part 2 of the discussion on #paediatricfebrileconvulsions. As mentioned earlier, #febrileconvulsions occur in 25% of children with #fever and cannot be prevented. There is also no way to predict whether or not a child with fever would develop febrile convulsions. There is evidence of genetic involvement; 24% of those with febrile convulsions have a family history. 30% of children who have a #febrileseizure will have another one during a subsequent illness. Regular ("around the clock") use anti-pyretics (fever-reducing medicines such as #paracetamol and #ibuprofen) has not been shown to reduce incidence or recurrence of #febrileseizures. Current guidelines recommend the use of anti-pyretics (either paracetamol or ibuprofen, not both) for comfort rather than control of fever. So what can we do for a child who has a fever? 1. If a child is unwell, take the child's temperature. 2. If the temperature is above 38°C, and the child is alert and responsive but miserable, ensure that child is kept hydrated and made comfortable. 3. Remove a layer of clothing to make the child more comfortable. Cold or tepid bath or shower may not reduce a fever and may make the child more uncomfortable and distressed. 4. Paracetamol or ibuprofen may be given if the child is in pain or distressed. 5. If a child has a febrile seizure at home, ensure that the child is in a safe environment. Remove objects surrounding the child and loosen tight clothing, but try not to restrain the child. Take the child to the hospital for assessment. Please seek immediate medical attention in the following conditions: 1. Child is less than 3 months of age and has a fever, 2. Child appears very unwell with lethargy, poor interaction, inconsolability, fast heart rate, or shortness of breath, 3. Child's temperature is 41°C or higher, 4. Child has had a seizure. This information was obtained from the article Paediatric Febrile Convulsions in the February 2016 issue of the #AustralianPharmacist. (at Miranda Day and Night Pharmacy)
