Management of febrile convulsions within the pre-hospital environment

Febrile children are a common presentation to health-care services with febrile convulsions being a relatively frequent call to the ambulance service. Traditionally paramedics have felt less comfortable in the assessment and management of paediatrics, especially in nonconveyances and discharging on scene.

Febrile convulsions are convulsions occurring in children aged six months to six years presenting with a fever above 38oC but without any signs of central nervous system infection (AAoP, 2011). Most commonly they occur between six months and three years of age with a peak occurrence of 18 months (Paul et al, 2015). Any diagnosis of a febrile convulsion made in a child aged over six years old should be made with extreme caution. Febrile convulsions are the most common cause of convulsion within paediatrics (Paul et al, 2012).

Febrile convulsions occur within all ethnicities; within the Caucasian population 2–5% of children will suffer from a febrile convulsion. Other ethnic groups have an increased risk compared to Caucasians with 5–10% of Indian children and 14% of children from Guam suffering febrile convulsions (Paul et al, 2015).