19 - status epilepticus Flashcards Preview

Emerg > 19 - status epilepticus > Flashcards

Flashcards in 19 - status epilepticus Deck (11)
1

def. status

5 or more minutes without gaining consciousness in between

2

7 main etiologies of SE

1. withdrawal
2. toxins
3. acute structural injury - brain, stroke
4. cerebral injury
- infection, hypoxia
5. chronic structural
- prior intracranial injury or surg
- cerebral palsy
6. metabolic
7. chroncic epilepsy

3

M and M of SE

first episode 20-30%
- over 30 minutes has neuro damage
- generalized respnd better to Tx

4

5 important Hx questions

1. time of onset
2. Hx of prior
3. injestion of toxins/etoh
4. assoc. Sx
5. Mex Hx

5

Phx for SE

mainly need to take care of ABCs

6

investigations for do

1. glucose
2. CBC, lytes, drug levels, VBG, Ca, Mg,
3. ECG, LP, CT head - defer until seizure stopped

7

Tx of SE

ABC
D50W if hypoG
benzos and phenytion

8

3 benzos to use

1. lorazepam -2-4mg IV - preferred
2. diazepam 5-10mg, IV
3. midaz - 10mg IM

9

3 meds to use of not stopping

ICU for
1. phenobarbitol
2. midaz IV
3. propofol

10

6 non CNS complications of SE

1. CVstress
2. hypotension
3. resp failure
4. rhabdo
5. increased para - bronch secretion
6. non cardio PEdema

11

when to suspect pseudo seizures

when other Tx are not working