seizures

Question 1

treatment

Answer 1

STARTTHEM ON HIGH FLOW OXYGEN

check for obvious reversible causes

Lorazepam: 0.1mg/kg (usually 4mg) as a slow bolus into a large vein. If no re-
sponse within 10min give a second dose.

he rectal route is an alternative

Buccal midazolam- 10mg in adults

IV infusion phase: If seizures continue, start phenytoin, 15–20mg/kg IVI, at a rate of ≤50mg/min. Monitor ECG and

General anaesthesia phase: Continuing seizures require expert help with paralysis and ventilation

never spend longer than 20min on someone with status epilepticus without having help at the bedside from an anaesthetist.

Question 2

what you are missing out on AE for seizures?

Answer 2

VBG/ ABG - for lactate

review the notes and medication chart to see if there is any history of seizure or if the patient is on any anti-epileptic medication.

You want to know how the patient has been over the last 24 hours and if there were any obvious precipitating factors.

Question 3

common causes of seizures with patient who had SAH and coiled ?

Answer 3

ischemia to the brain - stroke

infection

alcohol

electrolyte imbalance

hypoglycaemia

any new medications which lowers the threshold of seizures

Question 4

what is status epilepticus ?

Answer 4

seizures lasting more than 30minutes