MDM //

Patient meets criteria for simple febrile seizure. Patient is between age 6 months to 5 years Patient experienced only one seizure in 24 hours The seizure was generalized The patient was post-ictal with return to baseline and normal neurologic exam Patient is extremely well-appearing, normal exam, at baseline per parents. Full term birth, vaccines up to date. Tolerating oral intake, fever improved with medication administration. Doubt serious bacterial infection, meningitis. No crackles on exam, doubt pneumonia. No nuchal rigidity, patient not altered. Suspect viral etiology of symptoms. Likely viral etiology. Urinalysis negative, chest x-ray unremarkable. Influenza negative as well. Discussed alternating tylenol and ibuprofen as directed over the counter for antipyresis. Discussed strict return precautions for worsening of symptoms, increased respiratory effort, signs of CNS infection including but not limited to changes in mental status or vomiting, or fever for more than 5 days, or any recurrent seizures. Discussed prompt follow up with primary pediatrician in 24-48 hours for recheck or return to ED sooner if concern or if cannot schedule appointment. Mother comfortable with discharge.



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