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| {| {{table}} | | {{#ask: [[Is DrugClass::Benzodiazepine]] | ?SeizureDose=Dose | ?BrandName=Trade Name}} |
| | align="center" style="background:#f0f0f0;"|'''Timeline'''
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| | align="center" style="background:#f0f0f0;"|'''General Considerations'''
| | [[Scarlet_fever_1.2.jpg|thumb|"Slapped cheeks" and "white mustache" (circumoral pallor) typical of scarlet fever.]] |
| | align="center" style="background:#f0f0f0;"|'''Seizure Treatment'''
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| |-
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| | 0-5 minutes||
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| *Supportive care
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| |-
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| *Check blood glucose
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| |-
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| | *Establish IV/IO access
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| |-
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| | *Acetaminophen 15 mg/kg rectally if fever"||"*'''Benzodiazepine: first dose'''
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| |-
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| | **IV/IO access establised | |
| |-
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| | ***Lorazepam 0.1 mg/kg IV or IO (max = 4 mg), OR
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| |- | |
| | ***Diazepam 0.2 mg/kg IV or IO, (max = 8 mg)
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| |-
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| | **IV or IO access not achieved within 3 minutes:
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| | ***Buccal midazolam 0.2 mg/kg (max = 10 mg), OR
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| |-
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| | **IM midazolam 0.1 to 0.2 mg/kg (max = 10 mg), OR
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| |- | |
| | **Rectal diazepam (Diastat gel or injection solution given rectally) 0.5 mg/kg (max = 20 mg)" | |
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| | 5-10 minutes||*Give antibiotics if signs of sepsis or meningitis||*'''Benzodiazepine: second dose'''
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| | 10-15 minutes||||"*'''Antiepileptic: first therapy'''
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| | *Levetiracetam 40 mg/kg IV or IO, OR
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| | *Fosphenytoin¶ 20 mg PE per kg IV or IO§, OR
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| | *Valproate 20 to 40 mg/kg IV or IO, OR
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| | *Phenobarbital 20 mg/kg IV or IO, maximum 1 g, (expect respiratory depression with apnea)¥"
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| | 15-30 minutes||"*Obtain pediatric neurology consultation
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| | ** In patients with ongoing seizure activity despite two initial doses of benzodiazepine and a second-therapy antiseizure drug, preparation for a continuous infusion of midazolam, propofol, or pentobarbital should occur simultaneously with administration of a third-therapy antiseizure drug."||"*'''Antiepileptic: second therapy'''
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| | **Fosphenytoin¶ (if not already given) 20 mg PE per kg IV or IO◊, OR
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| | **Valproate (if not already given) 20 to 40 mg/kg IV or IO, OR
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| |-
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| | **Phenobarbital (if not already given) 20 mg/kg IV or IO, maximum 1 g (10 mg/kg if phenobarbital already given)¥, OR
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| |-
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| | **Levetiracetam (if not already given) 40 mg/kg IV or IO,
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| | *Consider pyridoxine if INH poisoning suspected
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| | **Infants (<1 year): 100 mg IV or IO in
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| | **Otherwise 70 mg/kg IV or IO (max = 5 g)"
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| |}
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