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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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| *Establish IV/IO access
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| *Check blood glucose
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| *If fever, [[acetaminophen]] 15 mg/kg rectally
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| || | |
| *'''Benzodiazepine: first dose'''
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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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| **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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| ***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 | |
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| *Give antibiotics if signs of sepsis or meningitis
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| *POC electrolytes, if available
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| *'''Benzodiazepine: second dose'''
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| |-
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| | 10-15 minutes
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| *'''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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| |-
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| | 15-30 minutes
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| *Consider intubation, if not already performed
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| *Pediatric neurology consultation
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| *'''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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| **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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| **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 **Otherwise 70 mg/kg IV or IO (max = 5 g)
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| |}
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| ^May be ineffective for toxin-induced seizures and contraindicated in [[cocaine toxicity]]
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