Febrile Convulsion

mn'l'lHomJ!li.l'mn~U'ltJ Febrile Convulsion"

, .I. ~ll:lUniitntTl'lir1~1r1'l.uftr1U'lmlmlElmli'tJl'jh1mnlu 11 rnrmnn

.c. .(: 1\ .•. . Q d iI ' ~ 'J1 l ''''''~ ~2. jU1~1l1'ln~lnn 'lJS'tHm~'rJr1'illJllUVlr1lnn(1l1Q\HlIJf111 18 II'111UIllllJlJ'UllHllJ)

3. rl111~1!:l1im'llmnnJ~VllJf1~hnl metabolic (electrolyte. calcium. magnesium,

glucose)

4. D~'bj~1!1'Ju~1l~n)\)n~lJlPi1Jm1l~!)4tla{j'~tll1gti 11'lfU EEG ,er scan lu~iJ1a~l'i'Ju

simple febrile seizure lla::; complex febrile seizure ~jj!lltll1iI'11.yjtJl'i~1J~11"liu

Ita:::'l.jiJil11lJHI'11Jnilh, m~lJlJtJ'i:::ft'ml~lJ tll

l1tlO0l11rnn

I. 1!1rll1JIl1l1l111N~'U : ilmfJl~Or~l~fl'lfj,)l~m)!)r1 ~lJI~mWUI'1:::11r111tnhu:::~'1l~1l'lljl!1111<i1l

lft'lJl1:::I~llhll'l ~1l"11l11t\U\11£Jl\1h1'1~~tfHJ 1~1ft'flll'1 '1 tft 111!)lHfJHlnlhtllU'lJOJ:::111ftl¥tl

2. 1l1'1'liJllUiilI'1Uf1l111iVl~'

3. hioli'ilJ'~r1 lwmlitili'ilin 111 Diazepam 0.2-0.3 nn.mn. 1111H"llftlftlll'll>il lumrullln

I<fUlil!)V'I~l'hj'lt\hn~ Diazepam 0.3-0.5 un.znn ft'1Ul~lJmlmmll:rnA jlI. ..., i!".., ••...Q ~ "'" .q,.!:':' I ,

4. ltmrj'ihtJl1Q¥'I'lfn 1l1'1!Iltl'i;:'1'11YllJlI'111wn~lh:::llJU111i1lUlNl:::uum hJlln:::l!:lJUlh::1'!ll1 1'!~

CBe 'U', ' ~ .I"'~" .• A. "'. ,..:' •• 'I" ~A u"!:t'f~fln~Hl)~1J!llJl'1llnou 'lllJOlJ'lJOl)-l'lf 11'1ll111ft'1l11i>j'Ull-l'lJ111l:::m1l1t'f1mil'Ulll

'l</)'

~ ".'1 " 1 ~ ,.l .J.. " "'~I ~ ""l "l"~ ~ :'1" 'j5. UfHj1J11JI'1V'1flllJOlm5U1Ull'UtI lll1!)~fln~IMIJU11J1WIl runnu 1J 1ll1lJlllllll)JlluU!;,H dEl

luhHWl1Jl1\

6. lM't) 11lJi'lm:::ftllIU:::lhtil)~lJilr1'l 01llr11lfJln01111ltll'l i'il~lil'l ~

7. ml1~[JltlllimnU'Mi~mll rintermittent prophylaxis) l'tiU Diazepam lu'ti1~Il'Jtl'[,j'

1 ..." J ,,~ 'I '''' 1 .•..•• 1"'" D't,mUHjl ilfl)'onl'1nnn1lll1\:: lJUU I~ IUfln~II"llJ01Jtlll'lm 11.'If la2epam 0.2 UIl/llil}

fl#~ lHllll 6·8 i,1m lwi'J~ 24~,11J1111tl 'Uo~'I~nilJl'

8. 'hjllU:::u:::l1n~ Phenobarbital I1T!) Sodium valproatc uuu continuous

prophylaxis rctllmnii</)'!ll.!1\·i1 1l!.l!)l~~;;Mmlnl1in·:imn'Wl~ u~'I!.lDr~1\luilm1111i'i\"hihi'

!fim~tj 15ft"lJif11um[JH<il'l~ wlln~lIlJtll'l"<Ul~Ii1(Jl'Ulllmlf~ 2 omhl1't'lfi¥'lN"Iii'm.iUl~n

lIlflf)11

-.

"~f1lr~rrU1U1!J~J111 bnl1f11jll'11ff\l1ra'II~1!l1~lY!lUn+l A:!iItmH

, b A ~ !'.01QlJlnn11 >11 IflOH l'IU1'HUlIl'i1i'\l111'11ti'1I1ItH

1'1hJ'ilU ').

1nlJ11l'111h'l'lle~'~llr.hllutilh

)1i1,fuuiw,\'n

flu irm Wl~"J~,Jl ''IIri'1I11a~'lIil~:\1I11Ul1HllllI

1'Il1'lIl'llO~1I1a!JlljA'ljjtotll~f1ljl1'1'1IHII!'IIO'1H

Mtilll1ml,olm'h110Jl'h\'Ol diazepam

rn"flfH'nll

*4!01hi+l ~~llthf~O~ilnvnil 'l'1JlY'-lmi~fIlru~ollll'l'~nlllf1 'l~I. oV'IJ OlI~tI~ \llil!!~Ul) ~!lll~'llij"Ull'lU1Jl1ii

v""I ••••. D -1t ....- • '1

2. l!tllI1l5'lHi'1l1Wm"lfnUlUf111 5 Ulll

3. ~'j 1\l'h~111t1iirl11lJN~tlf1~'Utl~'j:::u\Jth:::!'I'llll~~~Ul~lJliilJ\llfll~1Hi ~tlii

IlH::!lh~

1iU110.l1H~,n1J·,\'n'011101

anterior fontanel

Name ..•..•.......•.........•.•..•.••..•..••.••••..BW .......•.. Kg

•

IV Adjust Non shock gr I,ll DHF2

M .•.•••••.. CC/Day =..... cc/hr tM+5% ..••.•.•...•....•...CC/Day= •.•....• cc/hrIII

Type IV

Het(%)

Urine (ml.)

>.......o:l~

'i:':ES'-'4

10

Pit .

8

6 --

I _ I (.. . • •• ec/hr) I II . I I I II . I I •

I

II

•

•

I I I

: -::. 7mUkg/hr: :I 'I (.....•cc/hr) ( cc/hr) I II I I II I (....•.cclhr) mllkl!/h. ( ccJhr) II I I I1 I I II ( •.•.•. ccJhr) 1 I II I I I

I 3 lIksUh I: I I ( cclhr)( cc/hr): /m r1 I : I

I - I I I1.5mllkJ!/hrt :: I I

I - I I I I KVOI I I II I I I

I II I I I2~1 : : I ::

I I I I

I - I I I. I'I I I I I 1

o t ".1 ': ' -, i:, _ I ! 11' : i I _ ,I -. ; I ' :I I - I I IShock time I 1 I . I I I - I I

1 2 3 4 5 (I 7 8 9 1011 12t13 14 151617 18~9 20 21222324 *5 26 27282930 Jl 32333435363138394041424314445464748 :Het....... : I I H t I : : I I

I I leT.... I Het II I I 1 I I

I 1 I : I I I 1I I 1_ I I I II I I I~::::::::~::~:::;::~~::;::::;::~~::;:::~:;.~~::;:::~::~I~::;:::;:::~::::~::;:::~I::~~;.~::::;:::~:::;::=,:

, I II I I I II I I I II 1 I I I

I I Itotal I I I I I

- I I

I Ii-I I I• I

Clinical

_1..1 _1..1· '" "'_'I 1"' •• •• '" <til 't..,... •• ~ •• 'I "' ~ ••..••a1fl1"nLa::a1nT'iLuilU\4Llua\Jt1ft1AnJ'ZIil\JUlJ'UJ 'ZIlail~ililnLA\Jn/ft\Jftm \4L'ZILila~ililnlA\Jn flTtV1U1C1GU)\J"flV"'"L\mYlt1Ut1'i11Jfl\4Y1

u ••

Urine out put"i::!l::tlth!DHF UftLab i'CYllpmii?

H' -tb:aU"Il"l:: dehydration

• a"i::~UMild dehydration~omti thmnw i'U1.I1::m"

imn~ltt• Moderation to severe dehydration 1ti\'l" lhr;tA~1:f:: ;~

7h.hnu'l1" i'I~"llB1Liv"~ln i'ut.I"l'::rn"B1M1"l'1~"iltl

,.~ai'lJl.h::m"il1M1,1,.n~

-wa CBC \'flJ

• WBC~5,OOOcell/alUIJJ,

• Pit ~ 100,000 L~aataU.&lJJ,, it ~" •.. A-R1Hct ily "Lnm'l1t.1nfl mL"~>10-20",(,vlnbasellne

,"v1'im 1,., !l"1"L1 ""U'-Lymp uae Atypicallymp~"if""'V"l"lL"mj'

-pulse i'5lUft::full

Pulse L~'11~L,lil"v1nmti

-BPOtl'"Lnm'l1't.Infi..-O'fI"l"01"l'''' vL'ilUn 9iMi ill~'ln'h

Lifmi;'mlL,lO..tvln&i1,r

·ifi'li'l1'l::tJ on 1CClkgfhr

·~hurlne SP,B\l'Wlf'1'] 1.1

1,015

~nq~ -ltii'li!ft"ua·linn1~tT"l';fi;f"M~oLft'1a"

-I.hnu~,] DD"L"iiv ii&lft" i'lJt.I'::m"D1Ml"l'13J1~ R~"U' £m~v"

&l1n

-U'1(;l'l11!lt"""tl'113J1n

-m::i'lJn"l'::thv ~'1Lt1"!" LM3ilDDn ~'1a,v•• iJ..l U •• •.• , •• T" ..•-umn ,H/\UL a"tl[hI01"Ji'lIIlI'l1'11o'tf~ LD::il::l'ltl'l1t1M10tlR'il1

'HtJ1lJR1t1

-Capillary refill >2 ~'IIo1n

-101ftCBe \'flJ

• WBC~5,OOOcelltalJ,lJaI.

• PIt ~ 100,000 l'tfftataU,&I&I,• ~.J" . I ••••••

-R1Hct '''IJ'iI" 10-20% tt11LRIJ""l'Dftila,,3%

-ijR'l1Nu.-tuniitlo"LabL'.II" AST/ALT"" Bun Cr1f".• ..ilLilRt"'ilati' Ca.hNa.t,

-BT<38D"Fl1

- pulse ,U, L~'1

- pulse pressure ~30mmhq

-02 sat <95%

-ti""'01"l'M1!lt\)L~lJif"

-hjUi'li'l1'1::ltJ"na1 4·(;'

-Ui'I"'1'1::iI~iI"<O,5CC/kg

-"huri;,e sp,L~lJif"a~1l!

1-010·1-015

\1n~" -lih-'::;"111'1::"110'lloL'II" M"""'11'1'" M1t1t;iihmn U\l"891O'tlnfl"

"fl"ii" lD ""t.ID9Il~ii"la!J,J Crepitation, Rhonchi M~D wheezing

-L~lJiltl1n1tJ1h::'n'lloil1M1'

-mi"Convalesence

-ltiftfla"ilu1"li'otl 24 'lSIJt9lVl&lGiil"t~t11n9l1ti

-UR CBC "11

• WBC>5,OOOcel/lalJ,~IJ.

• Pit> 100,000 L'tfftR',au.&tIJ,

-fhHct ftfl"..t""ID'IIot.lnfiMla Stable

-Llh'i::;'] pulseti',l\iI::U"l'''!'} ~ •••• SI •• t

-BPD\I ~"mm'l1t1nfl fl1&1fl1'1::"1

Ln" pulse pressure"::fl~1"

-02 sat >95%

.Ui'li'l1'1::0Dmnnn-l11-

2CCIkg/hrL'IIo 8 'l1&1,

Age Heart rate (~~",",ii) SBP (&I&I,1.1-.B")

100-170 65-85

90-120 .. 70·90

80·120 80-100

70-110 90-105

65-110 95-110

60-95 100·120

55-85 110-135

0-3 I~v"3-6Liio"

6·12L~0,"

1·3tl

3-.6iJ

6-12tl

12iJ

OBP (1JIJ,U'fD") RR (R;",",n)

~ 111:"6).r7:lJI'lfl'l::1JU\\11JhU,i'I::L1"Jll.i1ufl1nq<;l1,"Lilnu~~t.I"l'::L'YIf'i1.nu

45-55

50-65

35·55

30-45

25-40

20;30

20-25

14-22

12-18

55-65

55-70

60-75

60-75

65-85

~1\a~vHct

-il1~<1U=30-35%

·,)111> 1-1OU=35-400/0,-0111>1oil=38-42%,

'W\\ru~=38-42%• w

'W'J!1U=42-48%..filJl:0111n'i1.r!JI"I::n1'~1nHl hflDHF

\ltJUL\l~1JVi"l'::\iilJ.,6i80?l77H"l2J\\1

,,:atl 2556,

Ideal Bodyweight

£11~$6tJ=(!l1 QLiJ'I\1JX2JBl!J>6U=!l1IJx3nn, ,

;

en rrrsua ::;£)1mrul ~l:.I'l-uLtl6'I\lfia1 AnJ'lI £)\1~tb 1:.1t"iAtI a ~n.n3J2I'"~"iULt"i\l fi'n 1:.111J16'1<Pi£)\I"i1 1:.1\I'm "[~LL'n'YlU''Yl"i11Jnufi~ ... .Clinical e.laLab ~f!Jf!J.rni1'nlLa::m'i<n'i.\l·h\lmv

• 1~6f\l -aa CBC 'nU _BT>3S.5 QC...(!) ~~a\l,n'i::~un'i::~'v

raJ L ,,: .J' '"• WBC>15,000cell/au.~~. LLa::<n'i.\l'nU Toxic - <n'i.mwnv \lL'n~'iI'I-I>Vi'ifla<na\l,..,

c. f

~ a a 1 """" granule neutrophill ~.nn1'50%L~man~wm~ ~'I-I>flVa\l..~hCBG 'ilrn::LM'flflncHL\l'l-l> tJi~' \1""@) lfl~hav\l L6f~Vi::~' n • - R L'i.n •• Lnrn't'l n<n(<n'~flI~)

• 1~fi'l-l>Lav\l5~L~flVi.vL\lL~', L'I-I>L~nL~n~.n1'2L~fm3JLav\lVi!j~ 0 PH < 7.25 tp2 sat <95%

na.Vi.V L\l an n 0 P02 < 70 mmHg -NS= Coma score a~a\l 2 ~::IL'I-I>'I-I>

(!) Vi. VL\lmitflvViflu 21. Vr~'i\l:U~ ~~1h.hn :Ua.v3JmJa. VU1'Liiv.0 PCo2 >50 mmHg

•e.laCXR 'nU Infiltration Lrillif'l-l>

VilvL\l~'Uln, Vi.vL\lla.iLtJ'I-I>,)\lVi.:: ••• W\l Lung 3JLaV\lBreath sound nriac

Age Heart rate (~-i'\l/'l-l>'Yi) SBP (~~.:U'iflYl) DBP (~~.:U'iflYl) RR (~-i'\l/"t.lYi)

0-3 L~fl'l-l> 100-170 65-S5 45-55 35-55

3-6L~fl'l-l> 90-120 70-90 50-65 30-45

6-12L~fl'l-l> VSO-120 SO-100 55-65 125-40

1-3U 70-110 90-105 55-70 20-30

3-6U 65-110 95-110 60-75 20-25

6-12U 60-95 100-120 60-75 14-22

12U 55-S5 . 110-135 65-S5 12-1S

~-;..

RCA (2R, 2C,lA)R=Respiratory rate L~~:ff'U\1~'ili1fl~~1n

R=Retraction ('il'ilnLL';~1'Un1'i\11ttl<i)L~~:ff'U

C=Color (cyanosis)C=Conscious changeA=Air entry fl(;lfl~

ViGlmhJ.v ')Lfifl:U'i::L~'I-I>~ibv1.••n.Gl\l\l::3Jn•• ::n''iVi.vL\l«~LVia.

.;

\1!l~u~tJLt1in1 n~j.JI11Tii<i;;1'Un1TYitl1U1i1T.Yi.\'I~'jJi11