A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. They most commonly occur in children below the age of three years old and should not be diagnosed in children under the age of 6 months or over the age of 6 years. In many cases, the first sign of fever is the onset of the seizure. It has been theorized that the seizure is triggered by the rapidity of the rise in temperature, rather than the actual temperature reached.

Febrile seizures represent the meeting point between a low seizure threshold (genetically and age determined) - some children have a greater tendency to have a seizure under certain circumstances - and a trigger: fever. The genetic causes of febrile seizures are still being researched. Some mutations that cause a neuronal hyperexcitability and could be responsible for febrile seizures have already been discovered.

The diagnosis is one that must be arrived at by eliminating more serious causes of seizure: in particular, meningitis and encephalitis must be ruled out. Therefore a doctor's opinion should be sought and in many cases the child would be admitted to hospital overnight for observation and/or tests. As a general rule, if the child returns to a normal state of health soon after the seizure, a nervous system infection is unlikely. Even in cases where the diagnosis is febrile seizure, doctors will try to identify and treat the source of fever. In particular, it is useful to distinguish the event as a simple febrile seizure - in which the seizure lasts less than 15 minutes, does not recur in the next 24 hours, and involves the entire body. The complex febrile seizure is characterized by long duration, recurrence, or focus on only part of the body. The simple seizure represents the majority of cases and is considered to be less of a cause for concern than the complex. It is reassuring if the cause of seizure can indeed be determined to have been fever, as simple febrile seizures generally do not cause permanent brain injury; do not tend to recur frequently, as children tend to 'out-grow' them; and do not make the development of adult epilepsy significantly more likely.

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Journal of Child Health Care current issue

Children's Nursing Education: Members club or street party?
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Creating space: hospital bedside displays as facilitators of communication between children and nurses
Lewis, P., Kerridge, I., Jorden, C. F.C. Wed, 20 May 2009 00:00:00 -0000
Over the past decades there has been a marked change in the physical environment of children's hospitals and the configuration of individual bed spaces. No longer the stark, clinical spaces typical of years gone by, the modern hospital bed space hosts a variety of visual displays reflecting different aspects of the child's life. Building upon ideas introduced by Lewis and informed by a recent qualitative study into hospital bedside displays, this article discusses the role that displays can play in developing, deepening and enriching relationships between nurses, patients and their families in the paediatric hospital environment. It discusses the links between hospital and home, the specific function of the display of photographs and the nurse's role in `knowing' the patient and facilitating links between hospital and home. It concludes that nurses' conscious observations of a visually rich environment may make a positive contribution to the care that they deliver for the benefit of their patients and themselves.
Influences on nurses' scoring of children's post-operative pain
Simons, J., Moseley, L. Wed, 20 May 2009 00:00:00 -0000
There is a lack of clarity as to why some nurses are not delivering optimal pain management to children post-operatively. This retrospective chart review study examined nurses' pain scoring on 175 children during the first 24 hours post-operatively. Data were analysed on the amount of assessments made, assessment scores recorded, as well as the age, gender and type of surgery performed. One-quarter of children had no assessment record of their pain in the first 24 hours post-operatively. When the pain tool was part of an observation chart, nurses recorded more pain scores. Nurses' scoring of children's pain is influenced positively by children under five years of age and those who undergo abdominal surgery. Nurses who had access to one document for recording vital signs as well as pain scores were more likely to assess and record a child's pain score than nurses who had to use a separate chart.

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