Emergency Department and Inpatient Clinical Pathway
for Evaluation/Treatment of Children with Febrile Seizures
Without Neurologic Disease

  • Concerning Features
  • Focality or Todd’s paralysis lasting > 15 min
  • ≥ 4 seizures in 24 hours
  • Duration > 15 minutes
  • Duration > 5 min +
    benzodiazepine
  • Failure to return to baseline mental status
  • Significant developmental delay
Assess for meningitis/intracranial/head or neck infection
  • Care is guided by History and Physical Examination to identify fever source and concerning features.
  • Routine lab tests are not recommended for simple febrile seizures or complex febrile seizures without concerning features.
  • Laboratory testing should focus on age appropriate fever evaluation guided by H&P.
  • AAP Guidelines for Febrile Seizures  
ED Evaluation
Posted: June 2016
Revised: October 2018 (Reviewed), September 2020
Authors: J. Hart, MD; M. Blackstone, MD; K. Dorland, RN; D. Bearden, MD; M. Sergonis, MD; V. Scheid, MD;
T. Kaur, MD; S. Haas, MD; and L. Adang, MD