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Sunday, February 14, 2010

Shake Up At IHOP

Just before 2100 hours we received a call for a child having a seizure at IHOP. We jumped into our bunker pants and started responding. Even today, the sound of the growler and the lights reflecting off everything make me smile. Even when it's cold I keep my window down.
 Since it's a pediatric call I talk with my engineer (he's a medic as well) during the ride about what we might encounter. We decided it was a 5 year old it was probably not a febrile seizure. There would more than likely be a preexisting seizure condition that the parents already knew about and that the staff had probably called. We figured that if the kid was of normal size he's be somewhere around 40 pounds which made the dose for Versed (in case he was still actively seizing when we got there) 1.8mg.

When we arrived we found the mother of the young boy holding his head while he rested on his right side on the floor. He was very hot to the touch. We tried out our new thermometer but it wouldn't work. Stupid new toy. The kid had a seizure that lasted about 10 seconds and the dad had helped his son to the floor. Since that time he had not been very responsive. The parents said that he was just starting to get sick today and that he had only had a fever for about an hour. He had no medical history, was taking no medications and had no known allergies. So far all of our assumptions in the rig (except for his weight which was dead on) were wrong. We quickly got him on some oxygen, got him out of his clothes and started cooling him and checked a sugar. AMR was on scene just a couple of minutes after we arrived.

The kid was a little old for your average febrile seizure but I guess no one had told him that. His parents did the right thing. They kept him from hurting himself by hitting anything and kept him on his side in case he threw up. The only other thing they could have done would have been to start cooling him off.


brian said...

Sounds like relatively quick onset in this instance, but in general it seems like we go on WAY too many calls where the kid has been sick for a while and the parents didn't think to give Tylenol or Motrin. Frustrating.

Any way...after the ambulance left, did you stick around and order up a stack of flapjacks?

Anonymous said...

Great blog as for me. I'd like to read something more concerning that matter. The only thing it would also be great to see on this blog is a few pics of some gizmos.
Katherine Karver
Phone Blocker

Firefighter/Paramedic said...

Brian- It is surprising how many times we run on febrile seizures where the parents have done nothing for the fever. And no, we did not order a short stack. We went back to the station and had ice cream.

Katherine- What would you like to read more about? And pics of our equipment and stuff? Let me know. I'm not above requests. Thanks for reading.

Ckemtp said...

Remember with febrile seizures, it's not necessarily about the actual temp of the patient, it's about a rapid change in the temp of the patient.. i.e. "spiking a fever" or rapidly cooling down from one that usually does triggers it.

I've seen fevers that were ruled to be febrile in etiology in kids up to 8yo. They're rarer, but they do happen.

Nice post, and thanks for the blogroll.

Firefighter/Paramedic said...

You're absolutely right about the rapid change in temperature causing the seizure. I never thought about it causing a seizure from rapid cooling but it makes sense. Thanks for the heads up.

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