A 7-year-old child with high fever and altered mental status requires urgent care. What complication should be closely monitored during transport?

In the case of a 7-year-old child with high fever and altered mental status, the presence of a fever, especially in conjunction with neurologic symptoms, raises concerns about potential complications such as seizures. High fevers can lead to febrile seizures, which are more common in children, particularly those aged between 6 months and 5 years.

Monitoring for convulsions is vital during transport because they can occur suddenly and may lead to further complications, including airway compromise, injury, or prolonged seizure activity, which can negatively impact the child’s overall condition. The urgency of the situation demands continuous observation, as any convulsion may require immediate intervention, such as administration of anticonvulsants or securing the airway if the child loses consciousness.

While hypotension, combativeness, and respiratory distress are important considerations in a critically ill child, the immediate priority in this scenario, given the symptoms, particularly the altered mental status and fever, is to be vigilant for convulsive activity. Prompt recognition and management of seizures can significantly influence the child's outcome, emphasizing the need for close monitoring during transport.