1. Febrile convulsions

2. What is a febrile convulsion?
A febrile convulsion (also known as a febrile seizure) is a common medical condition.
Approximately 3% of children aged 6 months to 6 years may have a convulsion when they have a fever or high temperature.

3. Convulsions
A convulsion is caused by a short burst of abnormal electrical activity in the brain.
This is when the nerve cells send “mixed-up” signals to each other.

4. Convulsions
These mixed-up signals may lead to a change in the child’s awareness or body movement.
Sometimes people use other names for convulsions such as fits or seizures.

5. What causes a febrile convulsion?
The febrile convulsion or seizure happens when the normal brain activity is disturbed by a fever.
It usually occurs without warning.

6. Signs & Symptoms Fever During the seizure the child may:
Become stiff or floppy
Eyes roll back
Become unconscious or unaware of their surroundings
Display jerking or twitching movements
Have difficulty breathing.
Have a blue face and lips

7. Management During the convulsion
Roll the child onto their side (recovery position).
DO NOT restrain the child

8. St John Management
After the convulsion
DSRABCD
Seek Medical aid

9. Advice from the Children’s Hospital at Westmead
The hospital recommends you ring 000 if:
It is the child’s first seizure.
The seizure lasts longer than 5 minutes.
The seizure occurs in water and the child has trouble breathing.
The child also has a head injury

10. Advice from the Children’s Hospital at Westmead
To reduce the fever you can use Paracetamol (Panadol).
Be aware this is not included in the first aid protocols of St John.

11. Advice from the Children’s Hospital at Westmead
These medications will make the child feel better from the fever but they DO NOT treat the infection that caused the fever.
They DO NOT prevent the seizure from occurring.

12. What can the doctors do?
Even though the high temperature is usually related to a viral infection, doctors will need to examine the child to try and determine the cause of the high temperature.
Further investigations or blood tests may need to be done to rule out other causes for the fever and convulsion.

13. Important points
Do not cool the child by sponging or bathing but remove excess clothes or wrapping! Regular Paracetamol will not prevent febrile convulsions!

14. Post treatment
The child will become tired after the seizure and will need time to rest and recover.
If the child remains drowsy or difficult to wake after sleep, you should seek medical attention.

15. Chances of a second one?
The chance of having another febrile convulsion in the following year is 30%, but this means that 70% (or 7 out of 10 children) will not have another seizure.
The risk of a second seizure reduces every year and it becomes extremely rare after children turn 6 years old.

16. OB12s Note the time the fit started and stopped on the OB12 .
Always write them as approximate times.
If you were not present during the fit, make it clear who is stating the times.

17. OB12s
For example ..’the mother stated that the fit lasted approximately three (3) minutes, from approximately 10:05 hrs to 10:08 hrs’.

18. OB12s Record the temperature accurately and the time taken.
If the child is being discharged from the post, always provide advice and discharge instructions to parent/guardian and record on the OB12 that you have done this.