• Febrile Seizure: Symptoms & Treatment

    Date Published: July 1, 2024

    What should first aid providers do if an infant/child has had or is having a suspected febrile seizure 6 months of age or older?

    • Recognize that they are having a seizure.
      • Common symptoms include unresponsiveness, rolling of the eyes, and shaking movements or stiffness of the arms and legs.
    • Call emergency response (911)
    • If possible, note the start and end time of the seizure.
    • Protect them from injury but do not restrain them.
      • Move items that could injure the infant or child while they are having a seizure. Use a blanket or clothing to protect their head but ensure that it does not cover the nose or mouth.
      • Do not put anything in the infant/child’s mouth
    • There is no evidence that cooling measures prevent febrile seizures.
      • Do not use an ice pack or cold water bath to cool them.
      • Do not use rubbing alcohol to cool them.
        • Rubbing alcohol (isopropyl alcohol) is dangerous to use to bring down a fever. It is quickly absorbed through the skin and is easily inhaled, placing the infant or child at risk for alcohol poisoning. Moreover, alcohol only cools the skin; it does not lower the internal body temperature.

    What should first aid providers do if the febrile seizure stops?

    • After the febrile seizure, help the infant or child rest on their side with their head tilted back to open the airway. Make sure the child is breathing.
    • DO NOT give aspirin.
    • Acetaminophen or ibuprofen (per manufactures instructions) can be given orally if the child is awake and able to swallow. If the child is not awake and acetaminophen suppositories are available, they may be administered. This has not been shown to prevent recurrent febrile seizures in the present or recurrent illness, but anti-pyretics may make the child feel better.
    • If the infant or child is awake and able to drink, provide them cool liquids such as juice or water.

    Information provided by members of the American Red Cross Scientific Advisory Council. Visit redcrosslearningcenter.org/s/science and follow x.com/redcrossscience for more information.

    References

    1. Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures Steering Committee on Quality Improvement and Management, Subcommittee on Febrile Seizures. 2008. doi:10.1542/peds.2008-0939
    2. Østergaard JR. Febrile seizures. Acta Paediatr. 2009;98(5):771-773. doi:10.1111/j.1651-2227.2009.01200.x
    3. Mittal R. Recent advances in febrile seizures. Indian J Pediatr. 2014;81(9):909-916. doi:10.1007/s12098-014-1532-2
    4. El-Radhi AS. Management of seizures in children. Br J Nurs. 2015;24(3):152-155. doi:10.12968/bjon.2015.24.3.152
    5. Shellhaas RA, Camfield CS, Camfield PR. Febrile Seizures. Encycl Neurol Sci. 2014;(December):281-282. doi:10.1016/B978-0-12-385157-4.00298-0
    6. Mewasingh LD. Febrile seizures. BMJ Clin Evid. 2014;2014. http://www.ncbi.nlm.nih.gov/pubmed/24484859. Accessed June 11, 2019.
    7. Murata S, Okasora K, Tanabe T, et al. Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode. Pediatrics. 2018;142(5):e20181009. doi:10.1542/peds.2018-1009
    8. Schnaiderman D, Lahat E, Sheefer T, Aladjem M. Antipyretic effectiveness of acetaminophen in febrile seizures: ongoing prophylaxis versus sporadic usage. Eur J Pediatr. 1993;152(9):747-749. http://www.ncbi.nlm.nih.gov/pubmed/8223808. Accessed June 11, 2019.
    9. Strengell T, Uhari M, Tarkka R, et al. Antipyretic agents for preventing recurrences of febrile seizures: randomized controlled trial. Arch Pediatr Adolesc Med. 2009;163(9):799-804. doi:10.1001/archpediatrics.2009.137
    10. Rosenbloom E, Finkelstein Y, Adams-Webber T, Kozer E. Do antipyretics prevent the recurrence of febrile seizures in children? A systematic review of randomized controlled trials and meta-analysis. Eur J Paediatr Neurol. 2013;17(6):585-588. doi:10.1016/j.ejpn.2013.04.008
    11. Offringa M, Newton R, Offringa M, Newton R. Prophylactic drug management for febrile seizures in children (Review). Evidence-Based Child Heal A Chochrane Rev J. 2012;8(4):4-6. doi:10.1002/14651858.CD003031.pub2.Copyright
    12. Murata S, Okasora K, Tanabe T, et al. Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode. Pediatrics. 2018;142(5). http://publications.aap.org/pediatrics/articlepdf/142/5/e20181009/1066779/peds_20181009.pdf
    13. Hashimoto R, Suto M, Tsuji M, et al. Use of antipyretics for preventing febrile seizure recurrence in children: a systematic review and meta-analysis. European Journal of Pediatrics. 2021;180(4):987-997. doi:10.1007/s00431-020-03845-8
    14. Offringa M, Newton R, Nevitt SJ, Vraka K. Prophylactic drug management for febrile seizures in children. Cochrane Database of Systematic Reviews. 2021;2021(6). doi:10.1002/14651858.CD003031.pub4
    15. Loussouarn A, Devlin A, Bast T, et al. Consensus statements on the information to deliver after a febrile seizure. European Journal of Pediatrics. 2021;180(9):2993-2999. doi:10.1007/s00431-021-04067-2

    ARC SAC June 2018
    Revised June 2022

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