Seizure, tonic clonic, just arrived in ER
What will you do ?
ABC
Cardiac monitor
Call Anesthesia to be ready
iv lorazepam ( Ativan ) 2mg iv every 2 minutes
No IV access, give IM midazolam
Still seizing
Fix IV access
Given IV lorazepam, max dose 10 mg per day
Check vitals
Give glucose ( if low glucose ), possible thiamine and naloxone
Still seizing
Give fosphenytoin and monitor BP ,ECG and respiratory rate
Call ICU team
Call anaesthesia
Give propofol
Intubate
Stabilized, in ward or OPD
Wants to be Pregnant , give keppra, give folic acid, stop/limit smoking & alcohol
Avoid driving for 6 months ( private license )
