Academic Journal
When less is more: Overdiagnosis and overtesting in pediatric febrile seizures in the adult emergency department.
| Τίτλος: | When less is more: Overdiagnosis and overtesting in pediatric febrile seizures in the adult emergency department. |
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| Συγγραφείς: | Louie JP; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, 55454, MN, United States. Electronic address: louie003@umn.edu., Mattice T; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, 55454, MN, United States., Kovaleski C; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, 55454, MN, United States., Schneider K; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, 55454, MN, United States., Lunos S; Clinical and Translational Science Institute, 717 Delaware Street SE, Minneapolis, MN 55414, United States., Amoni I; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, 55454, MN, United States., Kaila R; Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, 55454, MN, United States. |
| Πηγή: | The American journal of emergency medicine [Am J Emerg Med] 2025 Oct; Vol. 96, pp. 58-61. Date of Electronic Publication: 2025 Jun 14. |
| Τύπος έκδοσης: | Journal Article; Research Support, N.I.H., Extramural |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: W B Saunders Country of Publication: United States NLM ID: 8309942 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8171 (Electronic) Linking ISSN: 07356757 NLM ISO Abbreviation: Am J Emerg Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1983- : Philadelphia, PA : W B Saunders Original Publication: [Philadelphia, PA. : Centrum Philadelphia, c1983]- |
| Ιατρικοί όροι (MeSH): | Seizures, Febrile*/diagnosis , Seizures, Febrile*/therapy , Emergency Service, Hospital*/statistics & numerical data , Medical Overuse*/statistics & numerical data , Unnecessary Procedures*/statistics & numerical data , Overtreatment*/statistics & numerical data, Humans ; Retrospective Studies ; Male ; Female ; Infant ; Child, Preschool ; Child |
| Περίληψη: | Background: Febrile seizures are a common pediatric condition, affecting about 1 in 25 children. Defined by a fever of 38 °C or higher without central nervous system symptoms or a history of seizures, they typically occur between 6 months and 5 years of age. Published guidelines recommend conservative management for simple febrile seizures (SFS) if the child returns to baseline. There is concern, however, about excess testing in general emergency departments. This study examined the occurrence of such unnecessary testing. Methods: This was a 10-year retrospective review from three emergency departments within a health care system. The study included children who met criteria for SFS and did not require hospital admission or ED transfer. Variables collected included age, temperature, tests ordered on each child: complete blood count, blood culture, nasal viral testing, urine culture, spinal fluid culture, head CT, and disposition. Results: A total of 699 children presented with either a first or subsequent febrile seizure. First time febrile seizure, the mean age was 1.89 years of age as compared to subsequent febrile seizure, mean 2.78. As a combined group, only 264 (37.8 %) of children did not undergo any testing or studies. Children who underwent a lumbar puncture, blood culture or head CT had normal/negative results. All children were discharged home. Conclusion: Febrile seizures are common in pediatric emergency cases, yet a majority of children with simple febrile seizures evaluated in adult EDs still undergo unnecessary testing. This underscores a need for collaborative education and resource use in these settings. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest All authors have no conflicts of interest or relevant financial relationships to disclose. |
| Grant Information: | UM1 TR004405 United States TR NCATS NIH HHS; UL1 RR033183 United States RR NCRR NIH HHS; UL1 TR000114 United States TR NCATS NIH HHS |
| Contributed Indexing: | Keywords: Community emergency departments; Evidence-based guidelines; Pediatric emergency medicine; Simple febrile seizures (SFS); Unnecessary testing |
| Entry Date(s): | Date Created: 20250618 Date Completed: 20251008 Latest Revision: 20260506 |
| Update Code: | 20260507 |
| DOI: | 10.1016/j.ajem.2025.06.029 |
| PMID: | 40532406 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-8171 |
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| DOI: | 10.1016/j.ajem.2025.06.029 |