Febrile seizure??

MedicDank

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The last shift I worked we got dispatched to a 15 month baby having trouble breathing. When we got on scene we were met by the parents in the street ( FREAKING OUT), I got out of the ambulance and the parents hand me their baby who was actively seizing. I place the baby in the back and start asking the mother question like " how long has this been going on" and " has the baby had a fever today", " what medical history does the baby have". Foster mom states the baby has been acting like this for about 5 minutes. There is no medical history, and the baby had a fever earlier but it went away and no meds were given. We txp to baby code 3 to a Childrens hospital. 1.5 mg Versed given IN with relief, baby did have fever of 103, all clothes stripped off. Baby was stable the rest of the ride. Now here's where I start re thinking everything, once we transfer the baby to the er bed the baby began posturing with back arched and would stay like that for minutes at a time. You see the Dr's look at eachother and say " uhh ohh". Do you think this may have been a case off SHAKING BABY or something other than a seizure cause by high fever?
 

OnceAnEMT

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I feel like the posturing would be maintained continuously if there was trauma. Can a tonic-only seizure occur as a febrile seizure instead of tonic-clonic?
 

teedubbyaw

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Can you tell us more about your findings on the kid? Ever any alertness? Vitals? Pupils?
 

Handsome Robb

Youngin'
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Why the emergent transport if versed alleviated the seizure? Any antipyretics administered? Sounds like a pretty clear cut febrile seizure. The arching you're describing sounds like Sz activity.

Did the baby have any sort of circumferential bruising? Did you ever make it inside the home? Did the baby/mother have any complications during pregnancy or delivery. Any recent illness prior to this? Did she receive prenatal care? Any drug or alcohol abuse by mom during her pregnancy? Any N/V/D. How many diapers had the baby wetted today and was it normal/more/less than usual? What color was it? Any could odors? How were the tyke's vitals as far as HR, CBG, SpO2%. Pupils? Mentation? After versed did the kid return to any sort of lucidity or remain severely postitctal? Even with versed on board they should regain consciousness seeing as they metabolize it like gas on a bon fire.

I like peds calls but I'm a weirdo.
 

CANMAN

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Most certainly need more information. Could be post-ictal waking up from the seizure, kids make all kinda weird movements post seizure, or kid coulda had a "traumatic nap" and have some sort of neuro injury. What did the neuro exam look like, and what did that patient's heart rate do during the seizure, and during the "posturing"?
 
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MedicDank

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Pt hr ranged from 170-210, I followed up with the er yesterday and they looked up the pt report and said the pt scans came back negative. Pt outcome was Febrile Seizure..

Thanks everyone for your imput
 
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