status epilepticus

Question 1

bloods taken in status epilepticus

Answer 1

FBC, Urea, electrolytes, magnesium and phosphate, LFTs, toxicology

Question 2

imeediate pharmacological managemet of early status (0-10min)

Answer 2

if IV access:

• loazepam IV 0.1mg/kg repeat 10-20min
• consider thiamine and glucose IV

no IV access:
- Diazepam PR (repeat after 15min)

Question 3

immediate management of established status (10-20 min)

Answer 3

phenytoin infusion

Question 4

immediate management for refractory status (>20min)

Answer 4

general anaesthesia

Question 5

referrals for status epilepticus

Answer 5

Discuss with senior member of the team

Contact critical care outreach team

Consider referral to Intensive Care Unit (ICU)

Question 6

when to consider ICU referral in status epilepticus

Answer 6

Failure to respond to medical management- contact prior to starting IV phenytoin infusion

Patient requires ventilator support

Patient requires blood pressure support

Deterioration of blood gas following medical management

Question 7

future management of status epilepticus

Answer 7

review by neurologists regarding future management and prophylaxis

future investigaions - CT head, EEG (differentiate subgroup of epilepsy), ECG