RRAPID STATUS EPILEPTICUS

Question 1

What is it? (2)

Answer 1

a seizure that lasts > 30 minutes

or

repeated seizures without regaining consciousness

Question 2

What a the symptoms? (2)

Answer 2

1. tonic clonic seizures

2. non-convulsive status is more difficult

Question 3

What maybe useful to confirm the diagnosis?

Answer 3

EEG

Question 4

ABCDE (1,1,2)

Answer 4

A

1. maintain airway
   - consider recovery position

B

1. O2 non rebreathe mask 15L/min via a resvoir mask

C

1. IV access
2. blood cultures

Question 5

Treatment (2, 4)

Answer 5

1. 1-2mg lorazepam up to a maximum of 4mg slow IV bolus
2. repeat if necessary after 5 mins

If seizure continues

1. IV phenytoin 20mg/kg (max 2g)
2. give at a maximum rate of 50mg/min
3. monitor ECG and BP
4. call for help - anaesthetist, ICU