FN: status Epilepticus Flashcards Preview

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Flashcards in FN: status Epilepticus Deck (16):
1

Definition

Seizue lasting >30min or repeated seizures w/o intervening conciousness

2

Investigations

BM
Bloods: glucose, ABG, U+E, FBC, Calcium
ECG, EEG

3

Investigations consider

AED levels
Tox screen
LP
BetaHCG
CT

4

Drugs

Lorazepam
phenytoin
Diazepam infusion
Dexamethasone

5

Lorazepam

2-4mg IV bolus over 30s
2nd dose if no response w/i 2min

6

Alternatives to lorazepam

Diazepam 10mg IV/PR (20mg max)
Midazolam 10mg buccal

7

Phenytoin

18mg/kg IVI @ 50mg/min
100mg/6-8h maintenance
Monitor ECG and BP

8

Phenytoin CI

Bradycardia or heart blck

9

Diazepam infusion

100mg in 500ml 5% dex @ 40ml/hr (3mg/kg/24hrs)

10

Dexamethasone

10m IV if vasculitis/cerebral oedema (tumour) possible

11

Acute Management

ABC
1. Oral/nasal airway, intubate
2. Suction
3. 10% oxygen
4. Capillary blood glucose

12

Step 2

IV access + bloods
1. U+E, LFT, FBC, glucose, calcium
2. AED levels
3. Tx screen

13

Step 3

Reverse Potential Causes
1. Thiamine 250mg if EtOH
2. 100ml 20% gucose unless glucose known to be normal

14

Step 4

Slow IV bolus phase
1. lorazepam 2-4mg IV
2. 2nd dose if no response w/i 2min

15

Step 5

IV infusion phase
1. Phenytoin 18mg/kg IVI (them 100mg/6-8h)
2. Or diazepam 100mg in 500ml 5% dex IVI

16

Step 6

RSI Phase
Never spend >20min with someone in status w/o getting an anaesthetist

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