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In May 2013, the National Institute for Health and Clinical Excellence (NICE) republished - as expected - the guidelines on the assessment and initial management in febrile children younger than 5 years, six years after the first draft. The paper proposes them very briefly, emphasizing (few) major news and reporting once more the grids based on an intuitive traffic light system. Even now, support points for an easy and correct practice of daily emergencies - the small, the large or the invisibile ones - are not negligible and should be better spread and adopted in different care settings dedicated to the assessment and care of feverish children.

regarding in particular the quality of the information parents receive. Material and methods A survey has been sent to primary care paediatricians, hospital paediatricians, in training paediatricians and paediatric nurses. The survey started from a clinical scenario (a 18 months old girl at her first febrile seizure). Information regarded: a) the incidence of febrile seizures between 6 months and 5 years of age; b) the probability of a second seizure; c) the efficacy of antipiretycs in the prevention of febrile seizures; d) the use of rectal diazepam in recurrent febrile seizures; e) electroencephalography indications. Results Data has been collected by 1025 health professionals: 162 hospital paediatricians, 604 primary care paediatricians, 92 paediatricians in training, 167 paediatric nurses. Only 45% answered correctly all the questions; 64% answered correctly the question regarding the incidence of febrile seizures (3-5%); 58% gave a correct answer to the question regarding the recurrence (20-30%); 75% answered correctly the question on the efficacy of antipyretics in the prevention; 75% think that diazepam by rectal administration should be used if the seizures lasts more than 1-2 minutes; 81% think that there are no indications for electroencephalography. Conclusions The research has strong limits due to the sample selection. The results, considering their limits, show a discreet knowledge of health professionals. Guidelines should be shared by all health professionals considering that less than 50% answered correctly all questions. Parents should receive correct information based on guidelines.

The degree of temperature reached during a febrile episode has been considered the main condition of risk for the onset of febrile seizures for many years. In theory, the administration of antipyretics, lowering the body temperature, could prevent convulsions and their recurrence: however, this axiom has never been confirmed. The evidence on the issue of antipyretics and febrile seizures, based on the results of five RCT, requires uniform behaviour according to recommendations contained in the guidelines: the systematic use of antipyretics does not prevent the onset or the recurrence of febrile seizures.