Seizures (Adult) Flashcards
(19 cards)
Recite Seizures Adult CPG
What is the clinical definition of status epilepticus?
Seizure activity lasting ≥ 5 minutes or ≥ 2 seizures without recovery.
What types of status epilepticus are included?
GCSE (generalised convulsive) and subtle SE.
What other causes should be considered in status epilepticus?
Hypoglycaemia, hypoxia, head trauma, stroke/ICH, electrolyte disturbance, meningitis.
What should be considered regarding the patient’s history in status epilepticus?
Any management plan or treatment already given.
What should be monitored if seizure activity has ceased?
Airway, ventilation, conscious state and BP.
What should be done if subtle SE is suspected?
Time-critical transport and consult for Midazolam.
What if the patient has fully recovered from seizure activity?
Consider Treat and Refer as per CPG TR0207.
What is the first action in managing generalised convulsive SE?
Manage airway and ventilation.
What should be given if the airway is patent during convulsive SE?
High-flow O₂ as per CPG A0001 Oxygen Therapy.
What is the dose of midazolam for adults that are not small, elderly or frail?
10 mg IM.
What dose of midazolam should be given for small (<60 kg), frail or elderly patients?
5 mg IM, repeat once after 5 minutes if required.
What is the IV midazolam dose if IV access is available?
5 mg IV.
What is the IV dose for small/frail/elderly patients?
2 mg IV.
What is the repeat dose of IV midazolam if no response after 5 minutes? (MICA)
2–5 mg IV, every 2–5 mins, max 30 mg total (IM + IV).
What is the dose for small/frail/elderly patients after 5 minutes without response? (IV MICA)
2 mg IV, repeated every 2–5 minutes if needed.
What should you consider if seizures persist after multiple doses?
• Consult for further dosing • Consider ETT as per CPG A0302.
What should be done if the patient has already received a full IM dose (10 mg) after no response for 10 minutes?
Repeat 10 mg IM once only (if not small/frail/elderly).
What else should be done if there is no response after 10 minutes?
• Consult for further dosing • Continue monitoring airway, ventilation, BP.
