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Seizures (CPG A0703)

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Stop

  • Consider other causes e.g. hypoglycaemia, hypoxia, head injury, stroke / ICH, electrolyte disturbance, meningitis

  • Consider eclampsia in pregnant Pts with no prior seizure history

  • Consult for Midazolam if subtle SE suspected or for further Mx beyond CPG

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Generalised convulsive status epilepticus

  • Mx airway and ventilation as req'd

  • If airway patent, administer high flow O2 as CPG A0001

  • Midazolam 10mg IM

  • Repeat Midazolam 10mg IM at 10 minute interval once only if seizure activity remains

    • Small (<60kg), frail or elderly patients should be administered Midazolam 5mg IM, repeated once at 5/60 interval if req'd

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Advanced Paramedic

  • If IV in situ: Midazolam 5mg IV

    • Small (<60kg), frail or elderly patients should be administered Midazolam 2mg IV

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If seizure activity continues >5/60

  • Midazolam 2-5mg IV repeated at 2-5 minutes if required

    • Small (<60kg), frail or elderly patients should be administered Midazolam 2mg IV, repeated at 2-5 minute intervals if required

  • Consider ETT as per CPG A0302 Endotracheal Intubation

  • (Max. 30mg IM + IV)

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Flow Chart

Seizures Flowchart.jpg
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