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Blog & Resources  > First Aid for a Baby or Child Who Is Having a Febrile Seizure: Essential Steps for Parents and Carers

First Aid for a Baby or Child Who Is Having a Febrile Seizure: Essential Steps for Parents and Carers

Febrile seizures can be a frightening experience for parents and caregivers. These episodes, which occur in young children with high fevers, typically last a few minutes but can seem much longer.

While alarming, most febrile seizures are not harmful and do not cause lasting damage.

When a child experiences a febrile seizure, the key steps are to keep them safe, cool them down, and monitor their condition.

Remove outer clothing to help reduce their temperature and ensure they are in a safe position where they cannot hurt themselves.

It's crucial to remain calm and time the seizure if possible.

After the seizure ends, place the child in the recovery position with their head tilted back to keep their airway clear.

For infants under one year, cradle them in your arms with their head lower than their bottom.

While most febrile seizures do not require emergency medical attention, it's important to know when to seek help.

Key Takeaways

  • Keep the child safe and cool during a febrile seizure
  • Place the child in the recovery position after the seizure ends
  • Know when to seek medical help, especially for prolonged seizures

Understanding Febrile Seizures

Febrile seizures are a common childhood occurrence that can be alarming for parents. They typically occur in young children with high fevers and are generally harmless, though proper understanding and management are crucial.

Definition and Prevalence

Febrile seizures are convulsions triggered by high body temperature, usually above 38°C (100.4°F). They most commonly affect children between 6 months and 5 years of age.

These seizures affect approximately 1 in 20 children, with the highest incidence occurring in toddlers around 18 months old. Boys are slightly more prone to febrile seizures than girls.

Febrile seizures are typically classified into two types: simple and complex. Simple febrile seizures are more common, lasting less than 15 minutes and not recurring within 24 hours.

Symptoms and Warning Signs

During a febrile seizure, a child may exhibit several distinctive symptoms:

  • Sudden loss of consciousness
  • Stiffening of the body
  • Twitching or jerking movements of arms and legs
  • Rolling eyes
  • Holding breath or changes in breathing patterns

After the seizure, the child may be sleepy, irritable, or confused for up to an hour. Some children might also experience temporary weakness on one side of the body.

It's important to note that febrile seizures typically last only a few minutes. If a seizure persists for more than 5 minutes, immediate medical attention is necessary.

Triggers and Risk Factors

The primary trigger for febrile seizures is a rapid rise in body temperature, often due to common childhood illnesses. These may include:

  • Viral infections (e.g. flu, common cold)
  • Ear infections
  • Tonsillitis
  • Certain vaccinations (rarely)

Risk factors that may increase a child's likelihood of experiencing febrile seizures include:

  1. Family history of febrile seizures
  2. Certain genetic factors
  3. Developmental delays
  4. Frequent fevers or infections

It's crucial to remember that while these factors may increase risk, many children experience febrile seizures without any apparent predisposition.

Immediate First Aid Response

When a baby or child experiences a febrile seizure, swift and appropriate action is crucial. The following steps outline the essential measures to take during this medical emergency.

Initial Assessment

Upon discovering a child having a febrile seizure, remain calm and assess the situation quickly. Call 999 or 112 for an ambulance immediately. Note the time the seizure began, as this information will be vital for medical professionals.

Clear the surrounding area of any objects that could cause harm. Remove furniture, toys, or other items that the child might hit during convulsions.

If possible, use a mobile phone to record a video of the seizure. This can aid doctors in diagnosis and treatment planning later.

Positioning the Child

Gently place the child on their side in the recovery position. This helps prevent choking on saliva or vomit and keeps the airway clear.

Support the child's head by placing a soft object like a folded jumper underneath. Ensure their head is tilted slightly back to maintain an open airway.

Take off their outer clothing to help cool them. Open windows or doors to allow fresh air circulation, as febrile seizures are caused by high temperatures.

Monitoring Breathing and Response

Closely observe the child's breathing throughout the seizure. If breathing appears laboured or stops, begin rescue breaths immediately.

Do not attempt to restrain the child or put anything in their mouth. This can cause injury and interfere with breathing.

After the seizure ends, the child may be confused or sleepy. Continue to monitor their breathing and keep them in the recovery position until medical help arrives.

Reassure the child calmly if they regain consciousness. Offer comfort but avoid giving food or drink until they have fully recovered.

During the Seizure

When a baby or child experiences a febrile seizure, prompt and appropriate action is crucial. Timing the seizure, managing body temperature, and ensuring safety are key priorities.

Timing the Seizure

Start timing the seizure as soon as it begins. Most febrile seizures last less than five minutes. Use a watch, phone, or clock to keep track accurately. If the seizure continues for more than five minutes, call 999 or 112 for an ambulance.

Record the duration of the seizure, as this information will be valuable for medical professionals. Note any changes in the child's behaviour or movements during the episode.

If possible, capture a video of the seizure using a mobile phone. This can aid in diagnosis later.

Managing Body Temperature

Febrile seizures are triggered by a rapid rise in body temperature. It's essential to help cool the child down during the seizure.

Remove any bedding and strip the child of a single layer of clothing to aid cooling. If the room is hot, open doors and windows to ensure a flow of fresh air.

Do not attempt to give the child any medication or fluids during the seizure. This could cause choking.

After the seizure, continue efforts to lower the child's temperature gradually. Avoid rapid cooling methods like cold baths, as these can be dangerous.

Ensuring Safety

During a febrile seizure, protecting the child from injury is paramount. Clear the area around the child of any hard or sharp objects that could cause harm.

Use a blanket or clothing to protect their head. Do not restrain the child or try to stop their movements, as this may cause injury.

Do not put anything in the child's mouth, including your fingers. Contrary to common belief, it's not possible for a person to swallow their tongue during a seizure.

Stay with the child throughout the episode. Once the seizure ends, help them rest on their side with their head tilted back. This recovery position helps maintain an open airway.

Post-Seizure Care

After a febrile seizure, proper care is crucial for the child's wellbeing and recovery. Providing comfort, conducting a thorough examination, and monitoring for any lingering symptoms are essential steps in post-seizure management.

Comforting the Child

Once the seizure subsides, focus on reassuring and comforting the child. Speak in a calm, soothing voice to help them feel safe. Gently position the child on their side in the recovery position to maintain an open airway.

Allow the child to rest if they feel drowsy, which is common after a seizure. Offer a favourite toy or blanket for comfort. Keep the environment quiet and dim to reduce sensory stimulation.

Stay with the child continuously during this time. Explain what happened in simple terms appropriate for their age and understanding.

Physical Examination

Conduct a careful physical examination to assess the child's condition:

  • Check vital signs: temperature, pulse, and breathing rate
  • Look for any injuries that may have occurred during the seizure
  • Examine the skin for rashes or unusual marks
  • Check the child's level of consciousness and responsiveness

Take note of the seizure duration and any specific movements or behaviours observed. This information can be valuable for medical professionals.

If the child has a high temperature, take steps to reduce it gradually. Remove excess clothing and use lukewarm cloths to cool them down.

Observation for Further Symptoms

Close observation is crucial in the hours following a febrile seizure. Watch for:

  • Changes in behaviour or alertness
  • Difficulty breathing or changes in skin colour
  • Persistent high fever
  • Signs of dehydration (dry mouth, sunken eyes, decreased urination)
  • Repeated seizures or prolonged confusion

Keep a record of any symptoms or concerns to share with healthcare providers. Most children recover quickly, but if symptoms worsen or persist, seek immediate medical attention.

Ensure the child stays hydrated by offering small sips of water or clear fluids. Monitor fluid intake and urine output.

Consider keeping the child home from school or nursery for 24 hours to allow for proper rest and observation.

When to Seek Emergency Medical Assistance

Recognising when a febrile seizure requires immediate medical attention is crucial for a child's safety. Certain signs indicate a need for urgent care.

Identifying Complications

Call 999 or 112 for an ambulance if complications arise during a febrile seizure. Seek emergency help if the child:

  • Turns blue or has difficulty breathing
  • Experiences repeated seizures without regaining consciousness
  • Has a seizure lasting longer than 5 minutes
  • Sustains an injury during the seizure

Parents should remain calm and time the seizure's duration. If possible, capturing a video of the seizure can aid in diagnosis later.

Seizure Duration and Frequency

Most febrile seizures last less than 5 minutes. However, if a seizure persists beyond this timeframe, it requires immediate medical intervention.

Emergency medical attention is necessary if:

  • The seizure continues for more than 5 minutes
  • Multiple seizures occur within 24 hours
  • The child doesn't recover quickly after the seizure ends

These situations may indicate a more serious underlying condition and require prompt evaluation.

Consciousness and Breathing Difficulties

After a seizure, it's normal for a child to be drowsy or confused. However, certain signs warrant immediate medical care:

  • Prolonged loss of consciousness
  • Difficulty waking the child
  • Laboured or irregular breathing
  • Persistent confusion or disorientation

Help the child rest on their side with their head tilted back to ensure they keep breathing. Monitor their breathing closely and call for emergency assistance if concerns arise.

Preventative Measures and Management

Proactive steps can significantly reduce the risk and impact of febrile seizures in children. These measures focus on managing fever, regular health monitoring, and educating those responsible for childcare.

Fever Management

Controlling a child's fever is crucial in preventing febrile seizures.

Parents should keep fever-reducing medications like paracetamol or ibuprofen on hand, following dosage instructions carefully.

Ensuring the child stays hydrated is essential, offering frequent small sips of water or electrolyte solutions.

Lukewarm sponge baths can help lower body temperature. However, cold baths should be avoided as they may cause shivering, potentially raising the internal temperature.

Dressing the child in light, breathable clothing and maintaining a cool room temperature can also aid in fever management.

Regular Medical Check-Ups

Routine health check-ups play a vital role in managing a child's overall health and identifying potential risks for febrile seizures.

During these visits, paediatricians can:

  • Monitor the child's growth and development
  • Assess any underlying health conditions
  • Update vaccinations to prevent fever-causing illnesses
  • Discuss family history of febrile seizures or epilepsy

These check-ups provide an opportunity for parents to discuss any concerns and receive personalised advice on managing their child's health.

Keeping a record of the child's medical history, including any previous febrile seizures, can be helpful for healthcare providers.

Educating Caregivers and Family

Proper education of caregivers and family members is crucial in managing febrile seizures effectively. This includes:

  1. Recognising the signs of a febrile seizure, such as sudden stiffness, twitching, or loss of consciousness
  2. Learning first aid techniques for managing seizures, including placing the child in the recovery position
  3. Understanding when to seek emergency medical help

Caregivers should be taught to remain calm during a seizure and to time its duration.

They should also be informed about the generally benign nature of febrile seizures to reduce anxiety.

Sharing this knowledge with all family members and regular caregivers ensures a consistent approach to managing febrile seizures.

Professional Care and Follow-Up

After a febrile seizure, medical evaluation and ongoing care are crucial for the child's wellbeing.

Paediatricians assess the underlying cause, provide guidance, and monitor for potential complications.

Paediatric Assessment and Advice

Upon arrival at hospital, a paediatrician will conduct a thorough examination of the child.

They will check for signs of infection and assess neurological function.

The doctor will enquire about the seizure's duration, characteristics, and any previous episodes.

Parents should expect questions about the child's medical history and recent illnesses.

The paediatrician may order tests to identify the fever's cause, such as blood or urine analyses.

After the assessment, the doctor will provide advice on managing fevers and recognising signs of future seizures.

They'll explain when to seek emergency care and may prescribe fever-reducing medications.

Further Investigations

In some cases, additional tests may be necessary. These could include:

  • Lumbar puncture: To rule out meningitis, especially in younger infants
  • Electroencephalogram (EEG): To check for abnormal brain activity
  • Brain imaging: CT or MRI scans to detect structural abnormalities

These tests are not routine for simple febrile seizures but may be recommended for complex cases or when there's concern about underlying conditions.

The paediatrician will explain the need for any tests and discuss the results with parents.

Long-Term Monitoring and Care

Most children who experience febrile seizures do not require long-term treatment. However, follow-up care is important to monitor development and address any concerns.

The paediatrician may schedule regular check-ups to:

  • Track the child's growth and development
  • Discuss any recurring seizures
  • Adjust management strategies if needed

Parents should be educated on fever management and seizure first aid.

They'll learn to recognise signs of complications and when to seek medical attention.

In rare cases where seizures are frequent or prolonged, the doctor may consider anti-epileptic medication. This decision is made carefully, weighing the benefits against potential side effects.

Frequently Asked Questions

Febrile seizures can be alarming for parents and carers. Understanding proper first aid techniques, preventive measures, and long-term implications is crucial for managing these episodes effectively.

Knowing what to do and what to avoid can make a significant difference in a child's safety and recovery.

What steps should be taken to provide first aid when a child experiences a convulsion due to a high fever?

When a child has a febrile seizure, remain calm and place them on their side.

Remove any nearby objects that could cause injury. Loosen tight clothing, especially around the neck.

  • Take off the child's outer clothing to help cool them down
  • If the room is warm, open windows or doors to allow fresh air circulation.

After the seizure ends, help the child rest on their side with their head tilted back in the recovery position.

For babies under one year, cradle them in your arms with their head lower than their bottom.

What immediate actions are advised against during a child's febrile convulsion?

Do not attempt to restrain the child or stop their movements during a seizure.

Avoid putting anything in their mouth, including medication or liquids.

  • Do not try to move the child unless they are in immediate danger
  • Refrain from giving them a bath to cool them down during the seizure.

Avoid panicking or leaving the child unattended.

Stay with them and observe the duration and nature of the seizure to report to medical professionals.

How might one prevent recurrent febrile seizures in children?

While it's not always possible to prevent febrile seizures, managing fever can help.

Use appropriate fever-reducing medications like paracetamol or ibuprofen as advised by a healthcare professional.

Ensure the child stays well-hydrated during illnesses.

Dress them in light, breathable clothing when they have a fever.

Regular check-ups and promptly treating underlying illnesses can also help reduce the risk of febrile seizures.

What are the long-term implications of febrile seizures for children?

Most febrile seizures do not cause long-term health problems.

The majority of children who experience them develop normally and do not have an increased risk of epilepsy.

However, a small percentage of children may have recurrent febrile seizures.

In rare cases, prolonged or complex febrile seizures might be associated with a slightly increased risk of epilepsy later in life.

Regular follow-ups with a paediatrician can help monitor the child's development and address any concerns.

What post-seizure care should be given after a child has experienced a febrile convulsion?

After a febrile seizure, allow the child to rest in a comfortable position.

Continue to monitor their temperature and administer fever-reducing medication as advised by a healthcare professional.

Offer fluids to prevent dehydration.

Observe the child closely for any signs of illness or unusual behaviour.

Consult a doctor, especially if it's the child's first febrile seizure or if the episode lasted longer than five minutes.

At what age is it uncommon for children to experience febrile seizures, and what should be done if they occur?

Febrile seizures typically occur in children between the ages of 6 months and 5 years. They are most common between 12 and 18 months of age.

If a child older than 5 years experiences a seizure with fever, seek immediate medical attention. This could indicate a more serious condition and requires prompt evaluation by a healthcare professional.

For children outside the typical age range, it's crucial to rule out other potential causes of seizures, such as epilepsy or infections.

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