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Flashcards in status epilepticus Deck (11):
1

A child is seizing in the A:E department. What is the initial procedure?

A,BC and call for senior help. Gain IV access with two wide bore cannulas

2

what is your priority investigation?

check the blood glucose rule out hypoglycemia.

3

What medical treatment are you going to use?

benzodiazapam (IV)

4

what if you cannot gain IV access?

go for buccal midazolam or rectal diazepam

5

how long should you try for IV access?

10 minutes then go for intraosseous use lorazepam 0.1 mg/kg max of 4 mg

6

what if the benzodiazepines fail to control the seizure?

use phenytoin and if that fails you are getting the anaesthetist to put the child under GA.

7

what should you monitor at all times?

heart function!

8

patient is stabilised what investigations are you goin to do?

CT brain
try to find a focus?
FBC/CRP
blood culture
CSF
VBG
U&E
LFT
Ca
Mg
metabolic screen

9

when should treatment be started in status epilepticus?

with in 10 minutes of tonic clonic activity

10

definition of status epilepticus?

generalized tonic clonic movements lasting 30 minutes or more?

11

what is the timeline for treatment?

first 10 minutes- lorazeopam 0.1 mg/kg 30-60 seconds next ten minutes give another dose of lorazepam, next 10 minutes (20minutes) call for senior help,. fosphenytoin 18mg/kg
10 minutes
phenobarbitone 20mg/kg
10 minutes
refractory EEG ICU
rapid sequence induction.