Resident University of Minnesota Masonic Children's Hospital Saint Paul, Minnesota, United States
Background: Febrile Seizures (FS) are a common pediatric pathology that present to emergency departments (ED), with about 1 in 25 children experiencing a FS in their lifetime. The majority (between 65-91%) of these are simple febrile seizures (SFS). Seizures can only be deemed FS if there is a fever of 38०C or higher, no signs of CNS infection or inflammation, no metabolic derangements that could be the cause of seizure, and no other history of seizure. A FS can only be defined as simple if it is generalized, shorter than 15 minutes, and does not recur within a 24 hours. There is a well defined protocol for management of FS by the American Academy of Pediatrics, which helps distinguish children who may present with a more complex picture from those who present with SFS. If the child is otherwise neurologically healthy, back to baseline, and meeting all criteria for simple febrile seizure, this protocol states that laboratory tests and neuroimaging need not be performed. Objective: The less invasive approach to SFS management is well incorporated into pediatric emergency departments. However, there is a gap in studies that assess whether community-based ED are following these protocols. It has been theorized that community ED may be putting children with simple FS through unnecessary laboratory testing and neuroimaging. This study serves to assess whether excess exposure to testing is occurring when children present with SFS to community ED. Design/Methods: This is a 5 year retrospective review. We use ICD-10 codes to identify children who present with a FS. Patients populate two groups for separate analysis, first time FS and subsequent FS. Variables: MRN, age, temperature, which tests were completed and disposition. Summary of data will include demographics and frequency of each test. It will be determined whether each case was properly managed per AAP guidelines. A secondary analysis will determine the frequency of testing among children with recurrent FS. Logistic regression will be used to determine if certain factors in clinical presentation predispose a child to more workup.
