Browse categories and answer follow-up questions to refine your symptom profile.
Initial stabilization
Immediate priorities
Airway patency
If ongoing convulsions, lateral positioning and suction readiness
Breathing adequacy
Oxygen if hypoxemia or respiratory depression after benzodiazepine
Circulation status
If shock, isotonic fluid bolus 20 mL/kg and reassess
Bedside glucose
If glucose <3.0 mmol/L, dextrose
D10W 5 mL/kg IV
D25W 2 mL/kg IV
D50W 1 mL/kg IV for adolescents
Seizure time and response
Time since onset
If >5 minutes, benzodiazepine pathway
Return to baseline mental status
If persistent altered mental status, expanded evaluation and admission pathway
Fever and infection risk stratification
Signs of CNS infection
If meningeal signs, petechiae, toxic appearance, or persistent encephalopathy, meningitis encephalitis pathway
Immunization status
If underimmunized for Hib or pneumococcus, lower threshold for lumbar puncture when indicated
Classification and key decision points
Febrile seizure phenotypes
Simple criteria
Generalized onset
Duration <15 minutes
Single seizure in 24 hours
No prior neurologic deficit
Complex criteria
Focal features
Duration 15 minutes or more
More than one seizure in 24 hours
Postictal deficit
Febrile status epilepticus
Continuous seizure 30 minutes or more
Recurrent seizures without return to baseline
Escalation triggers
High risk features
Persistent focal neurologic deficit
Neuroimaging consideration
Persistent altered mental status
Lumbar puncture consideration
Concern for trauma
Neuroimaging consideration
Severe dehydration or inability to tolerate oral intake
IV fluids and observation or admission consideration
Unreliable follow up or caregiver concern
Observation or admission consideration
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.