EPILEPSY MANAGEMENT-AUSTRALIA
Treatment of status epilepticus in hospital. 1.Immediate measures Secure airway Give oxygen Assess cardiac and respiratory function Secure iv access Give lorazepam 4 mg iv or diazepam 10 mg iv Repeat after 10 mins if no response 2.In hospital Take blood for electrolytes, LFT, calcium, glucose, clotting, AED levels and storage for later analysis Measure blood gases Establish aetiology Give thiamine or 50% glucose solution if indicated Within 30 minutes In patients with established epilepsy: give usual AED orally, NG or iv 3.In patients with new-onset epilepsy or if seizures continue: fosphenytoin (18 mg/kg phenytoin equivalent), up to 150 mg/min with ECG monitoring or phenytoin 18mg/kg, 50 mg/min with ECG or phenobarbital 15 mg/kg iv, 100 mg/min Longer than ITU may be necessary minutes Anaesthetise with EEG monitoring Midazolam, phenobarbital, propofol, or thiopentone most commonly used Non-convulsive status Augment or reinstate usual AEDs Consider ...