Seizure CPG Flowchart And Care Objective

Question 1

How do we assess when to start Mx for Status Epilepticus?

Answer 1

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

Question 2

What other causes should be considered when assessing for Status Epilepticus? (6)

Answer 2

1. hypoglycaemia
2. hypoxia
3. head trauma
4. stroke/ICH
5. electrolyte disturbance
6. meningitis.

Question 3

What should be monitored in a patient with seizure activity?

Answer 3

Monitor airway, ventilation, conscious state, and blood pressure.

Question 4

What action should be taken if subtle SE is suspected?

Answer 4

Consider time-critical transport and consult for Midazolam.

Question 5

What is the management for Generalised Convulsive SE?

Answer 5

1. Manage airway and ventilation as required
2. administer high-flow O2 if airway is patent
3. IM midazolam

Question 6

What is the dose of Midazolam for patients ≥ 60 kg and dose for <60kg, elderly, frail?

Answer 6

Midazolam 10 mg IM

• if small, frail, or elderly, administer 5 mg IM, repeated once at a 5 minute interval if required.

Question 7

What should be done if seizure activity ceases?

Answer 7

Continue to monitor airway, ventilation, conscious state, and blood pressure.

• if patient has fully recovered consider treat and refer pathway

Question 8

What should be done if there is no response after 10 minutes and no IV access?

Answer 8

Repeat Midazolam 10 mg IM once only if the patient had a full dose initially.