/ EMERGENCY DEPARTMENT
PATIENT INFORMATION FOR YOUR CARE /

Care of the Patient who has had a Seizure

(Seizure, Febrile Seizure, Fever)

□Seizure

  1. Seizures are very scary to watch, but are not usually dangerous by themselves. Seizures that go on for too long (i.e. more than 10 minutes) or that cause the patient to be injured because of where/when they occur (e.g. fall off a ladder, crash a car) can be more dangerous.
  2. Unless you have medication specifically for this purpose, you cannot do anything to stop the seizure. Most seizures stop by themselves in 1-2 minutes or less. Do not try to hold the patient down or restrain them in any way.
  3. Do not put anything in the patient’s mouth (especially your fingers) while they are seizing.
  4. Turn the patient on his/her side so any saliva or vomit can drain out of the mouth.
  5. Call 911 if:
  6. The seizure lasts more than 5 minutes, or
  7. You are worried that the patient is having trouble breathing at any time.
  8. If the seizure stops on its own in a short time, and the patient appears in no distress afterwards, you may call 911 or come to the ER by another way.
  9. It is very common after a seizure for the patient to be tired, and often they fall asleep. They may also seem agitated or confused. This is usually temporary, and often only lasts 10-15 minutes.
  10. Do not give the patient anything by mouth until they are fully awake.
  11. The patient must not drive, operate heavy or dangerous machinery, bathe or swim alone, or engage in any other activity that would be dangerous should a seizure occur. You will be told by your physician when it is safe to return to these activities. Until then, they are forbidden.

□Febrile Seizure

  1. Read the instructions above under “Seizure”.
  2. Febrile seizures are not epilepsy. Epilepsy is the occurrence of 2 or more seizures without an obvious cause. In this case, the fever is the cause of the seizure.
  3. Approximately 25 to 30% of children who have a febrile seizure will have another one with this or a subsequent illness. Most children outgrow their febrile seizures by 5-6 years of age.
  4. Febrile seizures do not cause epilepsy, but the risk of a child developing epilepsy later in life is higher if he/she had a febrile seizure than not. The overall risk of epilepsy in a child that has a febrile seizure is only about 2%. This means that if your child has a febrile seizure, there is about a 98% chance he/she will not develop epilepsy.
  5. Your doctor has determined that your child is safe to go home. You should give your child any medication as it has been prescribed. You may use medications for fever as described below under “Fever – General Instructions”.

□Febrile Seizure (continued)

  1. Bring your child back to the ED if:
  2. He/she has another seizure
  3. You are worried that he/she is not getting better despite the treatment prescribed by your doctor
  4. You find the child inappropriately drowsy (e.g. not at naptime) or are unable to awaken them
  5. He/she is persistently vomiting and is unable to take medications as prescribed.

□Fever – General Instructions

  1. Fever is not the illness – it is part of the body’s response. The increased temperature make the body’s natural defences work better.
  2. The most accurate methods for measuring fever are to use rectal (in the bum) or oral (in the mouth) thermometers.
  3. A fever is defined as a temperature greater than 38ºC (100.4ºF) for at least 30 minutes.
  4. It is very common for the patient with a fever to feel tired, have muscle aches or mild headache, and generally feel unwell. The patient is often less interested in eating and drinking than usual. The main reason to treat the fever is to make the patient feel better, and to be more willing to drink enough fluids.
  5. General treatments for fever in patients of all ages:
  6. Encourage plenty of fluids.
  7. Do not overdress or cover the patient in heavy blankets. All the patient needs is to be comfortable.
  8. Take any medication as prescribed by your physician.
  9. You may give:
  10. acetaminophen (e.g. Tylenol™) ______mg every 4 hours
  11. ibuprofen (e.g. Advil™, Motrin™) ______mg every 6-8 hours
  12. Do not give aspirin (ASA) to a child with a fever unless specifically told to do so by your doctor
  13. It is safe to give acetaminophen and ibuprofen simultaneously, or in an alternating fashion (i.e. acetaminophen now, ibuprofen in 3 hours, then acetaminophen 3 hours later, etc)
  14. It is safe to give acetaminophen or ibuprofen with antibiotics.
  15. Bring the patient back to the ED at any time if you are worried that they are getting sicker despite following these instructions and taking any medication prescribed by your doctor.

These instructions are not intended to be all-inclusive, and may not cover all possibilities. If a new problem develops, or if you have any further concerns or questions please contact your primary care provider, Telehealth Ontario at (866) 797-0000, or return to the ER.

RoyalVictoriaHospital of Barrie, 201 Georgian Drive, Barrie, OntarioL4M 6M2 (705)728-9802

RVH-3288 (Rev Nov 29, 2006)