A Retrospective Report on Simple Febrile Seizure Management in a Pediatric Emergency Department

Clin Pediatr (Phila). 2024 Jun;63(6):764-768. doi: 10.1177/00099228231188607. Epub 2023 Jul 27.

Abstract

Objective: To determine whether pediatric emergency medicine physicians are compliant with the 9-year-old simple febrile seizure guideline created by the American Academy of Pediatrics (AAP).

Methods: A retrospective chart review of patients, ages 6 to 60 months, who presented to the emergency department between May 2011 and December 2019. Key variables abstracted were urine, blood, nasal viral swab, and radiographic results.

Results: The retrospective cohort of 285 children met inclusion criteria. Among 285 children, 342 studies were performed with a median of 1.2 studies per patient. There were 77 urine cultures obtained with 6 bacterial pathogens. Nasal viral swabs were performed on 65 children with 9 positive results. Blood cultures were obtained for 28 children and none were positive. Chest radiographs were performed on 37 children with 4 showing pneumonia.

Conclusion: The study results reflect areas of opportunity to update guidelines with a focus to consider obtaining urine studies, viral sampling, and chest x-rays.

Keywords: febrile seizur; pediatric emergency department; pediatric neurology.

MeSH terms

  • Child, Preschool
  • Emergency Service, Hospital*
  • Female
  • Guideline Adherence* / statistics & numerical data
  • Humans
  • Infant
  • Male
  • Pediatric Emergency Medicine / methods
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Seizures, Febrile* / diagnosis
  • Seizures, Febrile* / therapy