|
|
| (125 intermediate revisions by 3 users not shown) |
| Line 1: |
Line 1: |
| {| {{table}} | | {{#ask: [[Is DrugClass::Benzodiazepine]] | ?SeizureDose=Dose | ?BrandName=Trade Name}} |
| | align="center" style="background:#f0f0f0;"|'''Timeline'''
| | |
| | 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''' | |
| |-
| |
| | 0-5 minutes||*Supportive care *Check blood glucose *Establish IV/IO access *Acetaminophen 15 mg/kg rectally if fever ||*'''Benzodiazepine: first dose''' **IV/IO access establised ***Lorazepam 0.1 mg/kg IV or IO (max = 4 mg), OR ***Diazepam 0.2 mg/kg IV or IO, (max = 8 mg) **IV or IO access not achieved within 3 minutes: ***Buccal midazolam 0.2 mg/kg (max = 10 mg), OR **IM midazolam 0.1 to 0.2 mg/kg (max = 10 mg), OR **Rectal diazepam (Diastat gel or injection solution given rectally) 0.5 mg/kg (max = 20 mg)
| |
| |-
| |
| | 5-10 minutes||*Give antibiotics if signs of sepsis or meningitis ||*'''Benzodiazepine: second dose'''
| |
| |-
| |
| | 10-15 minutes||||*'''Antiepileptic: first therapy''' *Levetiracetam 40 mg/kg IV or IO, OR *Fosphenytoin¶ 20 mg PE per kg IV or IO§, OR *Valproate 20 to 40 mg/kg IV or IO, OR *Phenobarbital 20 mg/kg IV or IO, maximum 1 g, (expect respiratory depression with apnea)¥
| |
| |-
| |
| | 15-30 minutes||"*Obtain pediatric neurology consultation
| |
| |-
| |
| | ** 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''' **Fosphenytoin¶ (if not already given) 20 mg PE per kg IV or IO◊, OR **Valproate (if not already given) 20 to 40 mg/kg IV or IO, OR **Phenobarbital (if not already given) 20 mg/kg IV or IO, maximum 1 g (10 mg/kg if phenobarbital lready given)¥, OR **Levetiracetam (if not already given) 40 mg/kg IV or IO, *Consider pyridoxine if INH poisoning suspected **Infants (<1 year): 100 mg IV or IO in **Otherwise 70 mg/kg IV or IO (max = 5 g)
| |
| |}
| |
