status epilepticus

Question 1

status
epilepticus
Definition?

Answer 1

Status
epilepticus
(SE) is a single
epileptic
seizure
lasting
>
5
minutes
or
two or more seizures within a five-minute period without the person
returning to normal between them.

Question 2

First Step

Answer 2

First Step → 2 separate doses (10-20 minutes in between) of either:

√ IV Lorazepam “1st line in-hospital and if there is established IV access”. [or]

√ Buccal Midazolam [or] (Rectal Diazepam) “If no IV access or in-community”

Question 3

If 2 separate doses of either (IV lorazepam) or (Rectal Diazepam) or (Buccal
Midazolam) have been given but the seizure is still ongoing, move to step 2
◙ Second Step

Question 4

Second Step

Answer 4

◙ Second Step → IV Phenytoin
Important: Phenytoin is preferred over phenobarbital.

Question 5

◙ Third Step

Answer 5

◙ Third Step → Refer to ICU → Intubation, IV Phenobarbital.