Page 1 of 2: OSCE-Buster: Febrile convulsions - Counsel anxious parent

sajida · Credits: 105517 My Scrapbook My Reading List 6 Books

Mrs. Jones is a mother of Rosy who is four years old and has admitted with febrile convulsions. She is worried about the child and also concerned about the fits occurring in the future. You are the paediatric SHO , counsel her.

Good morning Mrs. Jones, my name is Dr……………. I am one of the doctors doing the clinics today. I would like to discuss about your sons condition and what needs to be done, is that ok?

After the detailed examination of your son and the investigations we think that he has what we call febrile convulsions.

Do you know anything about them?

This is a seizure brought on by fever and is usually appeared in a child aged between 6 months and 5 years. The child becomes unconscious and usually stiff with jerking of the arms and legs.

I know Mrs. Jones that was a very frightening experience for you, however febrile convulsions are not as serious as they look.

Is there anything you want to ask me before proceeding?

At this point I would like to tell you what you should do to prevent febrile convulsions. If your child is having fever, don’t over cloth him or over heat the room, try to keep him cool! Give him plenty of fluids to drink and also don’t forget paracetamol medicine to get his temperature down.

When your child is fitting you should lay him flat on his side with his head at the same level or slightly lower than his body. Note the time and wait for the fit to stop. It is not necessary to do anything else. If the fit doesn’t stop in 5 minutes we will give you medicine which is called diazepam and you have to insert it in the child’s back passage. This should stop the fits in 10 minutes. If doesn’t call 999. In any event let your doctor know what has happened.

in case if it is happening repeatedly, then we will give you medicine to be put into the kid's backpassage and our pediatric nurse will explain to you how to do that"

OTHER POINTS:
- The risk of having another attack gets rabidly less after the age of 3 years.
- It is not epilepsy. 99 out of 100 children with febr.convulsions never have other seizure after they reach school age.
- Febrile convulsions less than 30 min will never cause brain damage

Is there anything you want me to ask? THANK PATIENT/EXAMINER

bookworm · Credits: 6298 My Scrapbook

hi sajida.that was good info.Please do not forget to let the actor speak to you it has to be an interactive session.

Roche · Credits: 1185 My Scrapbook

Thanks.

Common questions by mum

Is my child likely 2 hav another convulsion?
It is possible that ur child may have further febrile convulsions, although ths becomes less likely as thet get older.febrile fits r rare over the age of 5.

Wat shud i do if my child does have another fit?
Dont panic!lie ur child on his/her side n make sure that d mouth is clear especially if thers any vomiting.take off most clothes n all blankets.a few convulsions r long lasting n may need an injection/rectal medication,so try n keep a note of the time.if the fit continues after 5mins contact ur doctor or ring 999.most often ,however the fit stops after a few mins n u shud then let ur doctor know.

rhaq · Credits: 887 My Scrapbook

hi good work people.
just want to say it's always good to say the child's name like rosy,then saying ur child.

LondonStudDoc · Credits: 206 My Scrapbook

This is a really common OSCE station, so thanks for the posts guys they're really useful! Like any communication station the key is empathy, eliciting concerns and responding appropriately.

neerjaneerja40 · Credits: 312 My Scrapbook

Good Job!

Can someone post a similar response to another scenario, where mum is very anxious as her 1 month old has jaundice( Bilirubin unconjugated 360) Repeatedly asking will my child's brain get damaged?

Thank you again

babo7511 · Credits: 200 My Scrapbook

thanks sajida

babo7511 · Credits: 200 My Scrapbook

thanks sajida

buble · Credits: 1325 My Scrapbook

What first aid should I do for a febrile seizure?

Note the time it started.

Lie the child on their side with their head in line with the body or slightly lower (the recovery position).

Do not put anything into their mouth or shake the child.

When the seizure stops, try to lower the child's temperature to make them more comfortable. To do this take off their clothes (if the room is warm). Then, when they have recovered enough to swallow, give a drink and some paracetamol or ibuprofen

buble · Credits: 1325 My Scrapbook

What should happen after immediate first aid?

The child should be seen by a doctor as soon as possible after a seizure for a check over to rule out serious illness. However, call a doctor or ambulance urgently if:

The child does not improve quickly once a short seizure is over.

A seizure lasts more than five minutes (this includes small twitching movements even if large jerking movements have stopped).

Another seizure starts soon after the first one stops.

The child has difficulty breathing.

The child was not fully conscious before the seizure or one hour afterwards.

You suspect a serious illness is the cause of the fever, for example, if you suspect meningitis.

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