“ Fever Fits brought on by fever or infection causing the child to fit as their body temperature control mechanism is not fully developed. Should stop by school age. „
Last night was awful. My two year old son went to bed at 8pm as usual, a little snotty and generally a bit warm due to a cold he came down with on Boxing Day. He's not the best sleeper in the world at the best of times so when he woke every hour I didn't really think much of it, until 11.30pm when he awoke with a squalling/coughing fit and when I went to him he was so hot I couldn't even cuddle him as the heat from his body was making my bare arms uncomfortable. I propped him up in our bed with my arm underneath him and a pillow under his head, gave him a big dose of Ibuprofen and settled myself down with my Kindle for a night of reading after realising sleep was probably out of the question with such a poorly babe next to me.
Then, after a couple of minutes, I caught sight of his eyes in my reading light and immediately knew something was wrong. It was strange, spooky in a way. They say babies and animals can see spirits, and that's exactly what came into my head - he was staring right over my shoulder with his eyes as wide open as they could go, his mouth gradually forming a large 'O' shape which for all the world looked like he was being tormented by something I couldn't see! The thing with Febrile Convulsions is that the child doesn't always shake or go into a true fit-like state so for the first few seconds it's hard to really understand what's happening, David had one last year while suffering from a chest infection so I do know the signs to look out for but last night he displayed such subtle symptoms that I honestly didn't click that he was fitting until I tried to shift his position and realised his legs were locked straight. A couple of very loud 'DAVIDs' and an attempt at distracting him by shining the light into his eyes did absolutely nothing, so I gathered him up and raced down the stairs yelling for Mark to come and help.
Calmness, you see, is key if your child has a Febrile Convulsion. You are absolutely no use to anyone if you're racing around like the proverbial headless chicken, and I'm the first to admit that I'm a total panic-merchant when anything like this happens. Mark took charge then, the action of me bringing him downstairs seemed to make David's symptoms more pronounced so by the time we'd got into the living room he was visibly trembling with huge massive pupils and absolutely no response to any of us. Remembering the advice we were given last time I soaked a tea-towel in cool water in an attempt to cool him down and Mark decided to call an ambulance rather than battle through New Years Day traffic to get to the Children's Hospital which is (not very) helpfully located in the middle of Birmingham city centre with roughly five car parking spaces. Having grown up with a disabled mum and cancer sufferer dad I'm very aware of how stretched the ambulance service is, but both the dispatcher and paramedic said we'd done the right thing as who knows what could happen during a forty minute car drive to the hospital - and I'd reiterate that to anyone who may be reading, don't worry in this instance that you're wasting the time of the ambulance as they are fully equipped to deal with any complications that may arise while you're on route to the hospital.
We were advised on the phone to put David into the recovery position as he'd begun to drool as the convulsion took hold and was making noises which indicated he was about to choke. I wasn't confident that he'd tolerate being in the recovery position as he loathes being 'held down', but it was testament to how poorly he was that he lay on his side like a good little boy without struggling whatsoever. I lay down on the floor next to him while Mark took various instructions from the lady on the phone, all tailored to the information we'd given about his condition - mainly regarding checking his breathing and ensuring the drool was sliding out of his mouth rather than him swallowing it. It's important to remember not to put your fingers in a fitters mouth even though that's the natural instinct when it appears your child is about to choke - providing they are in the recovery position the likelihood of a choking incident is minimal, there's much more chance of the afflicted little one deciding to chomp down on your fingers with enough force to cause damage! Sounds silly when you're dealing with such a little person, but the jaw is very strong so you do need to bear in mind that anyone with teeth (even toddler sized teeth!) cannot be trusted to be kind to anything that's placed in their mouth mid-fit.
Most Febrile Convulsions last for a few short minutes, although it seems longer due to the fact that it takes a while for them to come out of it. In the words of last nights paramedic, small kiddies will appear 'spaced out' for up to an hour after the convulsion itself has ended - and this was certainly true for David, who lay there for a good thirty minutes without moving a muscle and only swivelling his eyes to check where me and his dad were! There was a brief moment of panic when he didn't respond to the pain of a heel prick blood test, but this turned out to be a delayed reaction as a minute or two later he burst into tears and reached down (albeit half heartedly) to touch his injured foot. Once the initial observations had been made it was decided that David needed to go to the hospital, the paramedics reassured me that this was a precaution only and common practice for babies or toddlers who throw any sort of fit - if he'd been completely 'back to normal' by the time they'd arrived they may have decided to leave him at home, but to be honest I was glad to get him checked over in a hospital environment where anything untoward could be picked up and dealt with.
Luckily, within a few minutes of arriving at the hospital David was back to his usual self and spent our three hour wait entertaining the other parents with his cheekiness and general 'I'll sleep when I'm dead' attitude to life, bearing in mind it was now 3am and while I was flagging David had a burst of energy (typical after a convulsion of this nature apparently) which had him running around the corridors and attempting to kiss every nurse in the building! It was so good to see him like this after the pale and poorly sight of him during and after his convulsion.
Of course, I want to prevent this from happening again and the doctor assures me I must handle his various toddler illnesses well as the fact he has had a convulsion previously makes him susceptible to having more - that there was a thirteen month gap between convulsions is good news, as is the fact that the ones David has suffered have been relatively short (although this doesn't seem to be the case at the time). The main, and only, prevention is to bring their temperature down by stripping them off and giving doses of Ibuprofen and Calpol at regular intervals - but there really is only so much you can do. I learned last night that a cool bath isn't the best idea for a young child if they have a very high temperature as such a rapid cooling of the body can bring the convulsion on quicker and with more severe symptoms, if you feel they need extra help in cooling themselves down then a cool wet cloth is the best way forward - a good friend (fellow Dooyoo-er Gary, who is a long-term nurse) told me this morning that ice cubes on the wrist pulse is highly effective at bringing down a temperature, something I've actually scribbled down on the front of David's red book to remember for next time he starts overheating. Don't use blankets when children have a temperature, it's the body's way of telling you it's too hot so don't heat it up even more - I know the temptation to wrap them up warm is great, I'm a wrapper-upper myself, but seriously don't do it as you'll just end up making things worse. Strip baby off to nappy or knickers, sit them in front of a fan, try to keep them off your lap as your body heat won't be doing them any good or even go and stand outside with them - anything, just get that temperature down. The point to watch for, in little ones anyway, is that you don't cool them so quickly and thoroughly that they start shivering as that shows their body is becoming too cold, with that opening up a whole new set of potential problems. David's a wuss, he shivers if I pass him a bottle which is too cold, so it's hard really to work out sometimes if he's really cold or whether he's just being a bit of a girl - last night there was zero chance of bringing him to shivering stage as he was simply so boiling hot!
I actually do believe that they're not all preventable, they are in fact a 'good' reaction as going through a temperature induced convulsion can bring the body temperature down. It's still a fit though and it's bloody terrifying to witness but in the grand scheme of it, if the convulsion is managed properly while it's happening then it's unlikely to cause any other issues. It doesn't suddenly turn your precious babe into an epileptic, I'm absolutely not medically trained but suspect the main thing you need to be aware of is the possibility of choking as (with David at least) he loses his ability to swallow while his body is rigid through the convulsion - of course, if the convulsion lasts for a long time this opens up the worry of them getting enough oxygen but by this point the likelihood is that a paramedic will have arrived with the equipment and experience to keep your baby/child safe and well. When David had his 2011 convulsion it was because he'd been suffering with a largely symptomless chest infection which suddenly crept up on him with a ridiculously high temperature developing within less than an hour - I simply didn't have time that day to do anything to stop the convulsion occurring; luckily we were on the way to an appointment with our GP when the convulsion started in the car, so a brief 80mph spurt along the dual carriageway got us there in time for our wonderful GP to take charge and nurse David (then not even a year old) back to some semblance of health. I say luckily as his previous convulsion was much more serious due to the fact that it lasted for almost ten minutes with visible jerking of his limbs and he also lost controls of his bowels, I don't know how well I could have managed a fit (convulsion) of that severity by myself and the only advice I can give really is that the recovery position is a potential life saver so learn how to do it properly and quickly - it was the first thing my GP did when I rushed David into the building, even lying him in this position in his arms as he carried him through to the nurses room. While I suspect last nights convulsion could have been prevented if I'd noticed he was becoming more poorly during the night, the previous one would probably have happened whatever I'd done and was actually the thing which led to his chest infection being diagnosed and treated.
I'm gutted that I've got to give Febrile Convulsion a star, as a condition it deserves a minus number of stars as it's such a horrible thing for little people to go through and is horrendous to witness for mum and dad. I desperately want it never to happen again, but am aware of the fact that children can suffer these 'harmless' convulsions up to the age of five so am pretty confident that David will have another one at some point - none of my other children have ever had anything like this although mum tells me I was a Febrile Convulser myself up to the age of six, so maybe there is some hereditary factor in the mix somewhere.
All I can say really is don't panic, and if you think you are going to panic then entrust your child to someone who is less likely to inadvertently do the wrong thing through sheer worry. Call an ambulance, reassure the patient with soft words (as little physical contact as possible) and try to remember that it won't be very long at all until your baby is back to normal - in most cases Febrile Convulsions are seriously not as bad as they look, although that's very easy for me to say as I sit watching David (looking an absolute picture of health today) play as though nothing happened last night.
My little boy had these when he was much younger. The first time he was only about 8 months old and had just woken up from a nap. He had a cold, was quite grumpy and just generally not himself. He cried and as I lifted him out of his cot all of a sudden the crying stopped (suddenly) and went limp like a rag doll, his eyes rolled and was unresponsive. I called on his older brother who was only 4 years old at the time to grab the phone. By the time I got hold of the phone and managed to dial 999 he was awake again and looking around quite the thing!
Anyway, I asked for an ambulance to come so he could be checked at the hospital but as he was happily having a cuddle and breastfeed from me when the ambulance men arrived, they were reluctant to take him to hospital. I insisted and off we went. The Doctor at the hospital explained that it was more than likely to be a febrile convulsion as he had a cold and a bit of a temperature and this was his boy's was of cooling down.
He was referred to the neuro department and had a xray of his heart done and no abnormalities were found that could indicate anything more serious.
He did have a few more, as he got a bit older, usually when he was unwell and once after an immunisation.
I know they are very scary - especially the first couple, but someone told me it's no worse than an adult fainting (how true this i s I do not know) but it certainly reassured me as I fainted a lot as an anaemic teenager and never came to any harm!
They do grow out of it - the last time he had one was when he was about 2 and a half.
My 19 month old had been running a temp for a couple of days so i done what every parent does and took her to the doctors, they just said the usual just give calpol and keep her cool, so that's what we done, which wasn't easy as it was during a heat-wave. After a couple of days she was well enough for me to take her out shopping, anyway while in town she started to go blue and shake-panic started to take over so i decided to run to Boots and get the pharmacist to ring an ambulance, as it turned up she vomited everywhere-this is apparently a sign of a febrile convulsion.
Once at the hospital we were taken to the children's ward where she was monitored closely.
The information i received was as follows:-
A febrile convulsion (or seizure) happens when a child's core temperature reaches a certain point (usually around 38-40 degrees)where the body starts to shut down into self protection mode this is usually caused by a virus or illness, they start to shake as if cold yet they are hot and their face turn's ashen to blue in colour also 9 times out of 10 they are also sick afterwards, my daughter was extremely sleepy afterwards and i was told to let her sleep although there was a risk of her being sick again when she woke up(luckily she wasn't).
Although they look awful they are usually harmless when lasting under 15 minutes, although once the child has had one they are 30% more likely to have another, although if they last over 15 minutes there is a chance of either epilepsy or some damage to the brain, thankfully her's lasted only about a minute.
A nurse told me that the child can get these up until around the age of six because the body becomes prone to them although she did not tell me why this occurs, after the age of about 6 the child can properly self regulate their temp as an adult would thus making the convulsions less common.
Shortly after our admission to the hospital my daughter started to perk up and managed successfully to keep her temp down consistently allowing us to go home, we were later told that because the convulsion had reduced her temp she could control the virus better.
Ferbrile Convulsions is a fit caused by the body temperature, which usually happens in children aged between 6 months and 3 years old. Ferbrile convulsions are more common in boys than girls. They are brought on by a sudden rise in body temperature rather than an on going fever, meaning it can be difficult to know when they are going to strike.
The actual cause of the ferbrile convulsions is still unknown, which makes them even worse for the families when they happen to their children.
My little brother had these when he was younger, he is now 13, and they stopped a very long time ago now, I think the last time he had one was before he started primary school, or during his first year of primary school.
I was only young when they used to happen, but I remember quite vividly the convulsions happening, they are very much like epileptic fits in the way they happen. With my brother, Jack, his eyes rolled into the back of his head and he would fit. They didn't happen all that often, but when they did they were quite serious and usually resulted in a hospital trip.
There are two kinds of ferbrile convulsion, a simple convulsion and a complex convulsion. The simple convulsion is when the child has a fit which lasts less than 15 minutes and they do not occur again within the next 24 hours, they affect the whole of the body, whereas the complex are characterized by a longer fitting period, which occur more frequently and tend to be focused on one part of the body. The simple convulsions tend to be less serious, as the children "out grow" them normally by school starting age, and are less likely to induce brain injury or the chance of epilepsy in the childs adult future.
The type my brother had were, I think, the simple kind, but this by no means is anything like "simple".
The first time it happened was when my brother was very young, probably around 1yr-18 months old, my mum and dad had no idea what was happening, and called for an ambulance, it took the doctors months to find out what was happening with him, and to work out what he was having, he had been refered to Alder Hay childrens hospital in Liverpool, but was allowed home, and we were given a fact sheet to tell us what to do when he had the fits. They thought it may be something to do with his blood sugar and tested for diabetes, but there was no connection. And to this day we don't know what was causing the convulsions, it was a horrible time and terrifying when you didn't know what it was. We had to watch his temperature and were told to keep his blood sugar level up to try and stop the fits from coming on.
The most terrifying time anything happened was when we were at our touring caravan which we used to have in Morecambe, we had gone away for a few days like normal, and got up one morning. Jack was still asleep which was weird as he was only about 3 years old, he would normally have been up at 7am jumping around and driving my mum and dad crazy, but he was still sleeping.
By the time it got to around 9am my mum and dad thought something was getting very strange and went to check on him, on trying to wake him they couldn't and realised he had slipped into a coma. Luckily there was an ex nurse on the site who my family knew, and she checked him over and told us to get him to a hospital. Luckily he was brought out of the coma within a couple of hours and was back to his normal little self. More tests ensued but there were still no results and he was sent home.
To be honest, those are the two main times which I remember the fits happening so much, and it wasn't long after that coma that they stopped completely. His school had to have a letter to keep an eye on him so they knew what to do if he had a fit whilst there, but he didn't have them again after that.
He now is a happy 13 year old, he doesn't have any brain damage or anything else which was caused by the convulsions, so we were one of the lucky ones, he has grown into a healthy young man, and is great.
What I would like to say to anybody out there who has a child who has these convulsions, I know how frustrating it is having someone in the family who has these when the doctors don't seem to know what to do to stop them from happening. There are anticonvulsion pills which can be taken, which I don't think were available 10 years ago when my brother had the fits. And if your not given these, then ask about them. They are scary things, but the thing to remember is just to be calm and remember most fits last less than 5 minutes and rarely last up to 15 minutes. As I said my brother stopped having the convulsions when he started primary school, if not before then, and so it's good to know that children do normally grow out of the convulsions with no problems in their adult lives.
NB: Something I would like to add is that as a child when my baby brother went into his coma, it was the most terrifying thing I have ever been through, forget GCSEs, forget A Levels forget getting married, that was the scariest time I have ever had, I thought my baby brother was dead, or dying, I was only about 10 at the time, and I had no clue what was happening, although my mum and dad tried to explain what had happened I didn't understand. And I remember just sitting and crying to myself worrying about him. (I may have argued and fought with him but he was my little brother and now one of my closest friends and I loved him!) It's very important for parents to explain what is happening to their sibling, when I was younger my mum and dad did try and explain, and that did make it better in a way as I was told he was going to be ok. It's obviously hard when your worried so much about your child who has fitted and lying in a hospital bed, but do try and explain this to other siblings and they will be terrified at what is happening. :)
What is a Febrile Convulsion? (This description was taken from NHS Direct website)
Febrile convulsions are fits (seizures) that sometimes happen in a child with a high temperature. Febrile means related to fever. They can happen as a result of any illness that causes a high temperature, over 39C (102F).
Febrile convulsions usually happen between the ages of 6 months and 6 years.
Febrile convulsions can be frightening for parents, especially as they look like epileptic fits. Epilepsy is when a person has fits that arent just caused by fever.
Children who have one febrile convulsion, are more likely to have another during the same illness or another illness. There is a slightly higher risk that they will go on to develop epilepsy. This is very rare, but the risk increases if the fit is unusual or severe, if there is a family history of epilepsy, or if the child had brain or development abnormalities before the febrile convulsion.
Around 3 children in every 100 have at least one febrile convulsion.
Most febrile convulsions last less than five minutes.
My first-born was about 8 months at the time. He had been suffering with a small cold but nothing too major or worrying. Around 5am in the morning he woke up crying (nothing unusual there really as he didn't sleep through the night until he was 2 years old!). Anyway I put him into bed with me and my husband and this always soothed him and he would go back to sleep. He didn't. He fidgeted around and cried and basically got quite worked up. I thought a warm bottle of milk might calm him down some. So I got that and got back into bed with him. Offering the milk to him, he had a bout two mouthfuls and then pushed it away.
We carried on like this for a few more minutes until I realised he was not going to go back to sleep and I got up with him. It was about 5.15 am by then.
I got as far as the bedroom door when he suddenly started jerking and went all stiff, arching his back. I looked down at him totally confused and shocked. His eyes began to roll to the back of his head and all I could see were the whites. This is when I shouted at my husband that something was wrong.
He jumped out of bed and we rushed him into the lounge. He was burning up so we undid his baby grow and laid him across my lap in front of the fan, and my husband ran a wet sponge over his little body. He was still jerking around at this point and his eyes were still back.
This must have lasted about 3-4 minutes before we were so scared about what was happening that we dived in the car and drove round the corner to our closest hospital because this was only about 2 minutes away and we thought it would be quicker than calling an ambulance.
I remember sitting in the car with Daniel on my lap, he was still jerking and praying that he would not do anything stupid and leave me. I have never been so scared in my whole life. I didn't know what was happening and I thought I might lose my precious son. (It's filling me up now actually.)
When we got to the hospital they were shut, as there is no A&E department there. Didn't think about it when we left the house. Anyway we ran, holding Daniel, to the main doors and we just hammered on them shouting for someone to help us. After a few minutes someone opened the door for us and took us into a room. By this time due to the cold air outside, Daniel had stopped convulsing and was just lying quietly in my arms. He was awake though, which relieved me greatly.
The hospital staff were great and took us into a room where they laid Daniel on a table and took his temperature. It had come down but it was still high and they gave him a paracetemol suppository to bring it down even further. Then they called an ambulance to take us to another hospital a bit further away to do some checks on him.
When we got there they put a line into his hand, in case they had to administer antibiotics later. This was horrendous as he screamed and cried while they inserted the drip into his hand. We were taken to a ward and by this time it was around 8am or so and Daniel had actually perked right up. He was sitting up in his cot on the ward looking around as though nothing had happened.
We were allowed to take him home around lunchtime as his temperature had come down and stayed down for a certain period of time. I was so relieved and I think I cuddled him for the rest of the day. I also slept on the floor next to his cot that night in case anything happened again. It didn't. He has never had another one since then either. Thank God!!
WHAT I HAVE LEARNED SINCE.
The first thing I learned, and we brought the next day, was that we needed a thermometer of some sort and we brought a digital one from Boots. This has been one of the best things we ever brought as it helps to keep tabs on how illnesses are affecting the kids and can calm or confirm fears of a temperature within one second.
Next we looked into the convulsions on the net and found out the following:
These are pretty common. More common than you think, but I still think, even if you knew about it and knew what was happening, you would still be scared out of your mind if it happened to one of your kids.
Apparently, if the convulsion lasts for under 5 minutes then it is not necessary to call the hospital, as long as the childs temperature comes down. Whilst they are having the convulsion, you should try and lay them on the floor in the recovery position (harder said than done for a smallish baby having a fit!). Undo their clothing and do what you can to cool them down.
If after 5 minutes the convulsion is still going you should call 999. Don't do what we did and try to get to a hospital yourself. We were lucky as it was only 2 minutes away but if your child does need medical attention, then the ambulance can start working on them on the way to hospital.
If your child suffers with a convulsion they are much more likely to have another one in the future so it is advisable to keep an eye on their temperature if they get ill with colds and so on. Anything over 39 degrees is classed as high and can bring on a convulsion. However, they should have grown out of it by the time they go to school.
We had never heard of Febrile Convulsions before Daniel had one and I can honestly say I panicked and thought I was going to lose my baby, it was that scary!! I think maybe there should be a leaflet in your anti natal pack detailing this condition. If it is as common as they say (3 in every 100.) then it must have scared plenty of other parents out there who knew nothing about what was happening.
The NHS direct website was very helpful and there is a link to febrile convulsion page below
The hospital also gave us an information sheet, which was useful to read after the fact, but I wished I had had something before so I had an idea what was happening when it did. I would still have been scared but maybe not panicked as badly as I did.
I would have done everything the total opposite to what I did, like not put him in a warm bed between two adults, under a big duvet with warm milk!! This must have made it ten times worse!! But what do you know at the time eh?
Anyway - Daniel has never had another and neither has my daughter but it is something I am always acutely aware of when they become ill and I check their temperature regularly. I hope this may have enlightened or educated a few parents out there who like me were ignorant to this common condition, which scared the pants off me!!
Thanks for reading.
“Mummy, I feel pooooorly.” It’s 5 in the morning, and Fergus is standing at our bedroom door, wiping his nose with the back of his pyjama clad arm, sending a glaze of snot across his cheek. “Do you want to come and get into bed with mummy and daddy?” Silly question really. Soon he is tucked under the duvet between hubby and I, thumb in mouth, but quieter than usual. Now I can feel the heat his little body is generating, as it permeates his ‘PJ’s’, and realise that Fergus, usually a non-stop fidget and yacker, really isn’t feeling well at all. 5 minutes later, the thermometer, reading 38.3o, confirms the fact. It’s a rare parent who hasn’t experienced their child becoming unwell at some point during childhood. Those early days from 0-3, are particularly challenging times, as your child’s immune system struggles to get to grips with all the nasty bugs that exist out there in the world, usually encountering them for the fist time. This is a time when coughs and colds, especially prevalent during the winter months, seem to almost gang up causing a never ending onslaught to your child’s health. Even if the early days pass without any illness, sending your child into an environment with other children, soon puts paid to that. Nursery and playgroup, even sharing a childminder, creates the perfect environment for bugs to circulate. This year, Fergus was visited by a particularly festive little bug(ger). The very brave nursery nurses at his nursery decided to take Fergus, along with 40 other little treasures, along to see Cinderella. How wonderful I thought, and apparently it was a huge success. However, whilst Cinder’s was busy catching her Prince, Fergus was busy catching a cold. When the clock struck midnight, and the coach turned back into a pumpkin, Fergus’ pumpkin turned into a chest infection! Well used to the usual coughs and colds
that Fergus brings home, I was kind of expecting this one to just run its course before fizzling out. But when he woke the following night in tears, feeling even hotter, and looking pale, with a real barking cough, I decided to take him along to the open surgery at the health centre the next morning. The GP had a good listen to his chest, and a look in his ears. Her verdict, just a cold, but she did prescribe Ventolin syrup for him, in case his chest felt a little tight. Being a nurse, and therefore subscribing to the belief that there is a drug out there for every condition, I got a dose of this down him as soon as we got home. I’m sure it helped his breathing, but a word of warning. If your GP prescribes this, unless really necessary, don’t give before bedtime, it can make your child very hyper, and Fergus certainly was! One of the things you soon learn when you become a parent, is to stick your nose out on behalf of your child, when ever you feel it necessary, even when you wouldn’t do it for yourself. Just because your child has been given the all clear by a doctor, it doesn’t mean their condition will automatically improve, and it’s O.K to go back to see the GP when ever you feel unhappy with your child’s condition. I realise that this may sound more than obvious, but believe me, even as a nurse myself, I have had occasions in the past when I have feared being labelled a ‘pest’ by a surgery, for potentially returning when not necessary. The thing is, you are the best judge of your child’s well being, and you know when they are not right, so don’t be afraid to stick your neck out, it’s all part of the responsibility, the mammoth responsibility, that is being a parent. Your doctor is relying on you to monitor your child’s health after they have seen them, they can’t be there all the time for you, it’s your responsibility. Over the next couple of days, Fe
rgus’ condition did not improve. His chest sounded awful, and he seemed so pale and lethargic. When his temperature went up to 39.3o, and would not stay below 38o, despite paracetamol containing medicine(such as Calpol or Medised), I realised that he would need to be seen again. A quick note about medicine. I would always recommend having a Paracetamol containing medicine in the house when you have young children. Baby’s and toddler’s are not able to control their temperature as effectively as older children and adults, and high temperature can spike all of a sudden, when they are least expected. The good news is that there are plenty of measures you can take to help reduce a fever; A fever is a reading of anything over 37.5oC, Although many books will tell you that it is a reading of over 38oC, 37oC is the norm. Take off any layers of clothing, and strip your child off down to their nappy/pants. Remove blankets, and just keep a sheet handy for the night, when external temperatures can drop sharply. Turn down the heating, open a window, and generally do what ever is necessary to reduce room temperature. You will need to pop back and check the room temperature later, as well as your child’s. Children’s temperatures tend to swing quite violently when they are ill, especially after medication, so it’s important to check that they are not too cold. Administer medication as directed in the manufacturers directions. Calpol is a Paracetamol containing medicine that tastes of strawberry’s, and usually goes down well. Medised is a very useful medicine that not only contains Paracetamol, but also contains Promethazine, and helps to dry up all the runny noses associated with a cold. It also helps your child to sleep. It’s very important that you only use one of these medicines, as both containing Paracetamol, they should never be given together. If you find that having given P
aracetamol, your child’s temperature still remains high, consider giving a second medicine. Nurofen for children can be given from 6 months of age, and doesn’t contain Paracetamol. Apart from reducing a high temparature, it also eases all the aches and pains associated with colds, flu, earaches, tooth aches and the like. Friends of mine recommended this to me, and it’s very useful, especially if you want to give it to your child in the day, without causing drowsiness. In the old days, we used to call it ‘tepid sponging’, but it’s still very useful. Get a flannel and soak it in tepid water. Use it to wipe over your child’s body to help cool them off. Cold water can cause too much of a shock to the system. Be aware that cooling the skin, does not always lead to cooling a child’s core temperature. These are all fairly basic and straight forward measures that you can take to help reduce fever in a child. Ultimately, if there is an underlying cause, this needs to be treated, but whilst at home, obviously a parents greatest fear is that their child will develop convulsions with a fever. Febrile convulsions are more common in some children that others, and typically can occur after the age of 6 months in the presence of a high temperature. Common causes of these temperatures are chest infections, pyelonephritis(urinary infection that involves the kidneys), and ear infections. Febrile convulsions are rarely associated with epilepsy, although the fits caused are similar. Luckily we have not experienced convulsions in our children, but I do know that seeing a child fit, unexpectedly, is very frightening indeed(there are a couple of excellent opinions on the subject on this site). Try not to panic. When the fit, usually fairly short, finishes, place your child over onto their side in the recovery position, and carry out all the measures I’ve been through above, except giving anything by
mouth unless a child is fully conscious and alert. I have read advice stating that a doctor does not need to be called until a child has had 2 fits. I would strongly disagree. Call your surgery and seek advice. Your child needs to be seen, and the underlying cause of the fever treated. If you feel your child’s condition is deteriorating, following the fit, for example, they are drowsy and difficult to wake, their breathing is laboured, perhaps their lips are tinged blue, call an ambulance. If you don’t have any first aid skills, and don’t know about Cardio Pulmonary resuscitation(CPR), can I be so bold as to suggest that you take some classes. You never know when you may need these skills. Dealing with an emergency in the home is frightening enough, but to try to deal with one and not to know what to do seems to me to be the more frightening scenario. Anyway, back to Fergus, and as I say, luckily, he didn’t experience any convulsions. When he was seen again at the surgery, the doctor confirmed that his cough had progressed to a chest infection. Of course I didn’t want him to be ill, but in a way, I was relieved to know that my suspicions had been right, and that now he would receive antibiotics to sort the problem out. And so 2 days later, and Fergus is on the mend. No more fever, although I’m told his cough, which sounds more like a 40 a day’s, could continue for another couple of weeks. I’m continuing to give him Nurofen during the day, and Medised at night, as well as regular back and chest massages with Vick’s Vapour rub, wonderful stuff. Obviously, this is an opinion that could have been ten times as long, and I could have gone into far more detail about different childhood illnesses that can cause a high temperature. However, the message that I wanted to get across, was that being unsure of what to do when your child is sick, and feeling frightened, is
perfectly natural, but there is a lot you can do to make your child feel more comfortable, and to help reduce a fever, and there is help out there. Taking an unwell child to the doctor is never a waste of time, and it’s worth remembering that a child’s health status can change rapidly from one moment to the next. Trust your instincts! Even as a nurse and midwife, I have still used NHS Direct several times since becoming a parent, and I would recommend it to you if you are ever unsure of whether to call a doctor or not. Personally I think it best to speak over the phone, but there is also a very useful website. www.nhsdirect.co.uk I hope you and yours stay healthy this winter. Juliet
Febrile Convulsions - not something that I had heard of before I started training as a children’s nurse. The word Convulsion struck terror in my heart - how did the parents ever cope? Here was their child, normally bright and bubbly, who hadn’t been feeling too good and had been quite quiet all day, the one they remarked to their partner was "probably coming down with something", suddenly on the floor having some strange sort of fit while all sorts of horror stories are running through their minds. Next thing they know they are in hospital, surrounded by strange people, some of whom see these things every day and so treat it that way without a concern for how terrified the parents were just minutes before hand. The reality of this all hit me when I first looked after a child who had had a febrile convulsion. The child was fine, sitting up in bed watching the Tweenies, while her mum was on egg shells, obviously very distressed at what she had just witnessed a few hours before. I realised that, like myself, many people did not know much about this subject, and so I researched it, and this information has come in handy on a great number of occasions since. So what exactly is a Febrile Convulsion? As the word Febrile suggests, it is a "fit" that is brought on by a raised temperature of the child, and is extremely common in young children under the age of 5. This is due to their immune system not being as strong as that of an older child and so infection can get a grip quicker and as their body temperature increases to fight off infection, their "heat control" mechanism does not stop the body from producing heat - so the temperature continues to increase and causes the convulsion. It is thought that it is more likely that your child will have a Febrile Convulsion if you or your partner had one when you were younger and if your child usually suffers from high temperatures when unw
ell. Various people describe the fits differently, but the most common description is that the child first becomes floppy, then their body will stiffen and begins to shake uncontrollably. This can last for a few seconds, or a few minutes. The child will normally go very pale, and on some occasions go a little blue. Each child will react differently - some quickly return to consciousness, others take longer. What to do if your child has a febrile convulsion. This situation should be treated like any other emergency situation. First of all the environment should be checked for safety - remove anything that could harm your child while fitting, and put cushions against anything (like the fireplace) that you cannot move. If you can, take a note of how long the fit lasts, it will be helpful for the doctors to know this. Let the child "fit", do not try to hold them down and NEVER try to put anything into their mouth. If the child starts to vomit, their head should be turned to prevent choking. While the child is still unconscious they should be placed into the recovery position, which will maintain their airway. Try removing some clothing to help reduce their temperature. If the child continues to fit, an ambulance should be called (if you have not already done this). Most of the time the child has stopped fitting by the time they have reached the hospital, but if they haven't it is likely that they will be given rectal diazepam, to help relax the body and stop the fit. All children who have a Febrile convulsion should be seen in hospital, so that the cause of the convulsion can be figured out. In hospital, you would find that the main aim is to keep the child's temperature down. Your child will usually be stripped down to it's underwear, and given Paracetamol. Temperatures will be taken regularly and if the Paracetamol is not having a grea
t effect, Ibuprofen will be used alongside. These two drugs work amazingly alongside each other in reducing temperatures, and many children will be discharge home on these drugs. Paracetamol can be given 4-6 hourly, while Ibuprofen can be given 6-8 hourly 3 times a day, so most hospitals will alternate between the two drugs so that your child is given constant antipyretics. Another method of cooling the child down would be to sponge the child with a damp cloth, but there are many views on how appropriate this is, and many hospitals will have their own view on the subject. My local hospital sends parents home with detailed advice sheets that emphasise what the nurses have already told the parents, and there is always the option to ring the ward with any further concerns or queries - many parents find this to be of great benefit, and no ward should send you home with your child unless they are sure that YOU feel comfortable with what you should do if it happens again. Usually the cause is a viral illness, most of the children I have seen, have had tonsillitis stated as the cause of the convulsion. Many parents fear that this one convulsion will lead to their child having epilepsy, or brain damage. This is highly unlikely, and most children who have a febrile convulsion will recover totally from the ordeal, and while you will always remember it, the child will not remember the fit at all. Usually, most children who have had a convulsion will not have another one in the same illness, it is possible that they will have one if they are ill again, but usually most parents will recognise the early signs and make moves to try to keep their child’s temperature down. Seeing a child have a convulsion is very scary - I find it scary, and I do not have kids. I can only begin to imagine how terrible it must feel for a parent to watch their child go through this, but thankfully there is help for it, and a massive majority of c
hildren do not have any further problems.
I guess that I am writing this because I would have liked to have found the information when my children had their Febrile Convulsions. (I have no medical qualifications and write this from the heart as a mother who has some experience of this condition.) My three children have all had Febrile Convulsions or "Fever Fits" The eldest and the youngest only had one fit each but the middle one had 5 that he was hospitalised for, and at the time I couldn't find very much help to get me through. What is a Febrile Convulsion? A Febrile Convulsion, or "Fever Fit" looks very much like an epileptic fit, but is almost always accompanied by a high temperature, or underlying infection. Any infection which causes an increase in body temperature is enough to set off a Febrile convulsion in a child who is predisposed to having them. They occur in children whose body's heat control mechanism isn't fully developed and normally stop before the child starts primary school (age 4-5). The first fit will normally occur between 12-24 months. The child will become floppy and then will start to twitch uncontrollably, he will often dribble and may pass water. Although it looks scary, your child will not remember it. What should I do? The emergency treatment for any convulsion is the same. Lay the child on the floor and move anything out of the way that the child could hurt themselves on, make sure that they can breath (remembering that the muscle activity will make the breating erratic). If possible remove the child’s clothing to enable them to cool down and call for medical assistance. Most Health Authorities will recommend that the child is taken to the A&E department, where tests can be done to discover what the underlying infection is that has caused the fever and therefore the fit. If possible make a mental note of what time the fit starts, this will help the medical staff to know what treatment needs to be given and in
what sort of time scale. What will happen at the hospital? This will depend on the individual situation when your child is admitted. If the child is still fitting then he will almost certainly be taken to the emergency room, once there, a short history will be taken and your child will be given a drug to stop the fit, this is normally Rectal Diazepam and works really well. Unless your child is fully dosed up on Infant Paracetamol, he will also be given that rectally to help bring his temperature down. Once the fit has been stopped, your child will have blood and urine samples taken to find out what the underlying infection is so that the correct treatment can be given. Often your child will be admitted until the infection is discovered and the temperature has been controlled. What should I do when I get home? Try to carry on as usual, you will be given advice before leaving the hospital and if you are like me you will be on tenderhooks whenever your child has as much as a cold, but if your child is ill and you can control the temperature with Paracetamol and undressing there is no reason why most children would have more than one Febrile Convulsion. The only reason that my middle son had more than one fit is because he never showed any outward signs of having a temperature until the infection had set in and the internal body temperature was too high for Infant Paracetamol to work. Will I get through this? The simple answer is YES. Although you will obviously be worried almost all children grow out of Febrile Convulsions by the time they reach School age. There is a light at the end of the tunnel. Is there anything that can be done for multiple fitters? Yes, my son was put on Epilim to prevent him from fitting. Although it wasn't 100% it did prevent him from fitting before his "outward" temperature had raised. Finally, remember, youare not alone in this, there are people out the
re who have been through it, and if you talk about it with friends, the chances are at least one of them has been through it too.