febrile convulsion OSCE scenario
- as a straight PEM scenario → Status epilepticus scenario
- Explain to parent why this is not the same as epilepsy
angry parent
- Clarify history -
- type of movement
- duration
- post-ictal phase
- Source of fever is...
- No evidence that preventing fever/keeping temperature normal will prevent seizures
- Counsels re risk of recurrence (33%)
- increases if child is younger at first seizure
- increases with positive family history
- Counsels re risk of epilepsy (1% - similar to general population)
- increases with family history of epilepsy
- increases if febrile convulsion was complex to 5% - >1x in 24h
- increases if this seizure lasted >30 mins → 30-40%!
- Complex febrile convulsion warrants more in-depth investigations as with any child with low GCS
- management same as any seizure out of hospital and in hospital
- Gives seizure first aid advice
- start the clock
- safe surroundings
- place on side/recovery position once seizure stops
- do not give food/drink or put anything in mouth
- call ambulance if >5 min
- no long-term effect on brain development or function
- no routine rescue medication given, only by speicalist
- invites questions
- addresses concerns non-judgmentally
- global mark