MyCpdZw - Protocols Details

FEBRILE CONVULSIONS

Febrile seizures are convulsions that can happen during a fever (febrile means "feverish"). They affect kids 3 months to 6 years old, and are most common in toddlers 12–18 months old. The seizures usually last for a few minutes and are accompanied by a fever above 100.4°F (38°C).

Diagnosis

Remember these are very distressing to parents!

Establish that this is an uncomplicated, febrile convulsion:

· Usually between ages of 6/12 & 6 years,

· Occurs when fever rapidly rises above 38.5,

· Generalized, single seizure of short duration (<10 mins.),

· No focal neurological findings,

· There must be an identifiable fosus of infection.

40% are recurrent esp. in the < 1 year age group.

Risk of subsequent afebrile seizure .

Management

1. ABC’s, Resuscitate as indicated,

2. 100% Oxygen,

3. IV access,

4. Check BSL,

5. Diazepam IV (0.2 mg/kg) or Midazolan IV or IM (0.1 mg/kg),

6. May give rectal Diazepam (0.5 mg/kg) if IV access difficult,

7. If status develops give phenytoin IV 15-20 mg/kg over 20 mins. Followed by 3mg/kg IV

every 6 hours. If under 3 months use phenobarbitone IV 20 mg/kg over 20 mins.

Followed by 5 mg/kg/day in three doses,

8. A “septic work-up”, including LP, is recommended in:

· All children <6/12 old,

· In all those with seizures >10 mins &

· Anyone with clinical signs suggestive of meningitis.

9. As a general rule a child with an uncomplicated, brief febrile convulsion who has made

a full recovery & has good social set-up can be discharged after a period of observation,

although often admission for observation is more preferable option by parents,

10. Always discuss with LMO prior to potential discharge,

Any child who is discharged should be reviewed within 24 hours

Recent Protocols

COVID 19

COVID 19 is a disease caused by the most recently discovered coronavirus which is a large family of corona viruses causing illnesses. In humans it causes Respiratory infections for example Severe Acute Respiratory Disease (SARs) PRESENTATION Fever 77-98% Cough 46-82% Myalgia/Fatigue 11-52% Shortness of breath 3-31% Incubation period 14 days, most people develop symptoms between 5-6ays from exposure Stage1 (Early infection). Stage 2. Stage 3(Hyperinflation phase) Viral response---------------------------Pulmonary Phase----------------------Host Response *Anyone presenting with flu like symptoms should be assumed to be a COVID 19 case until proven otherwise*

WARFARIN OVERDOSE/ TOXICITY

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SUICIDAL IDEATION

Suicidal ideation, also known as suicidal thoughts, is thinking about or having an unusual preoccupation with suicide.

SPINAL CORD INJURY

Emergency signs and symptoms of a spinal cord injury after an accident may include: Extreme back pain or pressure in your neck, head or back. Weakness, incoordination or paralysis in any part of your body. Numbness, tingling or loss of sensation in your hands, fingers, feet or toes. Loss of bladder or bowel control.