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Simple Febrile: Laboratory Tests

The Simple Febrile Seizure CPG team concurs with the recommendation of the AAP (P. K. Duffner et al., 2011) not be performed as part of a routine evaluation of a simple febrile seizure. Specifically the AAP guideline states serum electrolytes, calcium, phosphorus, magnesium, blood glucose or a complete blood cell count “should not be performed in the routine evaluation of the child with a simple febrile seizure”. The recommendation is based on evidence from observational studies. In 2012,  Teran, Medows, Wong, Rodriguez, & Varghese, 2012) evaluated the usefulness of obtaining a CBC in children with a simple febrile seizure. They report 134/182 (73%) had a normal CBC, 42/182 (23%) had leukocytosis, and 6/182 (4%) had leucopenia. We value identifying the source of the fever, and treating the cause of the fever appropriately.

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.