When managing a 3-year-old boy who has just had a seizure with elevated temperature, what is the next best step?

In the management of a 3-year-old boy who has experienced a seizure accompanied by an elevated temperature, the focus should be on identifying the underlying cause of the fever. While antipyretics can provide symptomatic relief by lowering the fever, they do not address the root cause, which is essential in this scenario.

When a child has a febrile seizure, it is crucial to conduct a workup for the source of the fever to determine if there is an underlying infection or condition that requires treatment. This may involve taking a detailed history, a physical examination, and potentially laboratory tests or imaging studies to assess for conditions such as meningitis, pneumonia, or urinary tract infections.

The option to observe the child overnight may lead to delays in diagnosis and treatment, especially if the underlying cause of the fever is serious. Referring to a specialist may not be necessary at this initial stage unless there are specific complications or recurrent seizures that warrant further evaluation. Therefore, working up for the source of the fever is the best approach to ensure proper management and treatment of the child.