Seizures (Paed)

Question 1

Recite Seizures Paediatric CPG

Answer 1

Question 2

What is the definition of Status Epilepticus (SE)?

Answer 2

Seizure activity ≥ 5 minutes or ≥ 2 seizures without recovery.

Question 3

What other causes should be considered when assessing a patient with SE?

Answer 3

Hypoglycaemia, hypoxia, head trauma, stroke/ICH, electrolyte imbalance, meningitis.

Question 4

What should be considered regarding the patient’s management plan?

Answer 4

The patient’s own management plan and treatment already given.

Question 5

What should be done when seizure activity has stopped?

Answer 5

Continue to monitor airway, ventilation, GCS, and BP.

Question 6

What should be considered if subtle SE is suspected?

Answer 6

Time-critical transport and consult Clinician for Midazolam IM.

Question 7

What should be managed immediately in Generalised Convulsive SE?

Answer 7

Airway and ventilation.

Question 8

What should be given if the airway is patent?

Answer 8

High-flow O₂.

Question 9

What is the IM midazolam dose for adolescents (12–15 years)?

Answer 9

5 mg IM.

Question 10

What is the IM midazolam dose for medium children (5–11 years)?

Answer 10

2.5–5 mg IM.

Question 11

What is the IM midazolam dose for small children (1–4 years)?

Answer 11

2.5 mg IM.

Question 12

What is the IM midazolam dose for small & large infants (<12 months)?

Answer 12

1 mg IM.

Question 13

What is the IM midazolam dose for newborns?

Answer 13

0.5 mg IM.

Question 14

What IV dose is given to adolescents (12–15 yrs) if seizure continues > 5 minutes?

Answer 14

2 mg IV.

Question 15

What IV dose is given to medium children (5–11 yrs) if seizure continues > 5 minutes?

Answer 15

1–2 mg IV.

Question 16

What IV dose is given to small children (1–4 yrs) if seizure continues > 5 minutes?

Answer 16

1 mg IV.

Question 17

What IV dose is given to infants (<12 months) if seizure continues > 5 minutes?

Answer 17

0.5 mg IV.

Question 18

What IV dose is given to newborns if seizure continues > 5 minutes?

Answer 18

0.2 mg IV.

Question 19

How often can IV midazolam be repeated?

Answer 19

Every 2–5 minutes, max 5 doses total (IM + IV).

Question 20

What should be considered if seizures persist?

Answer 20

• Consult for more doses • Consider ETT per CPG P0301.

Question 21

What drug is contraindicated in this CPG?

Answer 21

Rocuronium.

Question 22

What should be done if seizure continues without IV access?

Answer 22

Repeat original IM dose once only.

Question 23

What else should be done if seizure continues without IV access?

Answer 23

• Consult for further dosing • Continue monitoring airway, ventilation, GCS, BP.