For a 2-year-old experiencing a febrile seizure after receiving ibuprofen, what is the best next step?

In the case of a 2-year-old experiencing a febrile seizure, administering cooling measures is the best next step. Febrile seizures are often triggered by a rapid increase in body temperature, typically associated with fever, and the primary approach in this scenario is to help reduce that temperature safely. Cooling measures—such as removing excess clothing, using fans, or applying cool compresses—can help to lower the body temperature and may decrease the likelihood of further seizures.

While the administration of medications like acetaminophen or ibuprofen may address the fever, they do not act immediately, and the seizure may already be underway when these medications are given. Observation without intervention is also not ideal, as it does not address the immediate concern of the child’s elevated temperature and the active seizure episode.

IV antibiotics are not indicated in this situation unless there is a clinical suspicion of a bacterial infection necessitating such treatment. In the absence of specific indications suggesting an underlying bacterial infection, initiating antibiotics would not be appropriate. Thus, initiating cooling measures is the most effective step to take in the moment to manage febrile seizures.