MANAGEMENT

BREATHING

AIRWAY CIRCULATION

TEMPERATURE GLUCOSE

BLOOD PRESSURE
 PR Diazepam 0.5mg/kg (max 10mg)
Seizure >5 mins
Impending status epilepticus
IV Diazepam 0.2mg/kg slow bolus
(at 2mg/min; max 10mg)
Seizures continue >5 mins
after Diazepam
Seizure >30 mins, without full
IV Phenytoin 20mg/kg
neurological recovery in between
in 0.9% NS over 30mins to 1 hour
Established status epilepticus Seizures continue >10 mins
after Phenytoin

IV Midazolam 0.2mg/kg bolus

(at 2mg/min ; max 10mg)
Seizure > 60 mins
Refractory status epilepticus OR
Consider intubation
IV Phenobarbitone 20mg/kg (max 1g)

OR

IV Sodium Valproate 20mg/kg (max 1g)

Why is it important to intervene with status epilepticus ?

Associated with high morbidity

• Cardiac dysrhythmia
• Metabolic derangements
• Autonomic dysfunction
• Neurogenic pulmonary edema
• Hyperthermia
• Rhabdomyolysis
• Pulmonary aspiration
• Permanent neurologic changes