Status epilepticus is sustained epileptic activity with
1. two fits without recovery of consciousness in between
2.single fit of >30 mins with or without loss of consciousness
Treatment aims at controlling seizures within 1 hour of admission.
STEP A (first 20 mins)
- Maintain ABC (airway, breathing, circulation)
- measure blood sugar
- take a brief history
- Administer Diazepam (10 mg iv over 1-2 mins)
- Administer Phenytoin (20 mg/kg)
IF SEIZURES ARE NOT CONTROLLED, GO TO STEP B
STEP B (20-60 mins)
- Give Phenobarbital or Diazepam infusion.
IF SEIZURES ARE NOT CONTROLLED, GO TO STEP C
- Administer General anesthesia or Thiopental infusion
Simultaneously, monitor BP, electrolytes and provide ventilation.