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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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| | We heard you. '''Our native WikEM app is back!''' Download from your app store now ([http://apps.apple.com/us/app/wikem/id576405449 iOS] and [https://play.google.com/store/apps/details?id=wikem.chris Android]). |
| | 0-5 minutes
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| | [http://mediawiki.org MediaWiki] |
| *Supportive care
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| *Check blood glucose
| | [http://apps.apple.com App] |
| *Establish IV/IO access
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| *Acetaminophen 15 mg/kg rectally if fever
| | [https://apps.apple.com App] |
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| *'''Benzodiazepine: first dose'''
| | [http://apps.apple.com/us/app/wikem/id576405449 iOS] |
| **IV/IO access establised
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| ***Lorazepam 0.1 mg/kg IV or IO (max = 4 mg), OR
| | [https://apps.apple.com/us/app/wikem/id576405449 https://play.google.com/store/apps/details?id=wikem.chris iOS] |
| ***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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| *'''Benzodiazepine: second dose'''
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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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| | 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 **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 lready given)¥, OR
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| **Levetiracetam (if not already given) 40 mg/kg IV or IO, *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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