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Prolonged seizure — DCH MCQ

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ModeratePaediatric emergenciesProlonged seizureDCH

A 2-year-old boy has a generalised seizure lasting 8 minutes at home and continues convulsing when paramedics arrive. Blood glucose is 3.8 mmol/L and temperature is 38.7°C. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Give buccal midazolam if trained and available

A convulsive seizure lasting beyond 5 minutes should be treated as prolonged, and buccal midazolam is an appropriate community rescue medicine when available. Objects in the mouth and restraint are unsafe. The pearl is to check glucose and seek urgent assessment after prolonged or atypical febrile seizures.

Reference: BNFc; NICE CKS Febrile seizure