1. Manage in Resuscitation Area
Convulsive Status Epilepticus:
Infants (Age >1 month), Children and Adolescents Guideline
Manage in Resuscitation Area
888 Call If Seizure Unresponsive To 1 Dose of Benzodiazepine or Airway Compromise at any time
Continue down algorithm until seizure ceases - Full guideline on Southnet
Airway management
High Flow O2
Obtain Blood Glucose – if BSL < 3.0 give 2ml/kg of 10% Dextrose
Consider pre-hospital treatment.
More than 2 doses IN TOTAL of Benzodiazepines should only be given only after discussion with SMO
Yes
Intravenous (IV) or Intraosseous (IO) Access? No
IM Midazolam 0.2mg (Max 10mg) OR
Buccal or Intranasal Midazolam 0.5mg/kg (Max 10mg)
Lorazepam 0.1mg/kg (Max 4mg )
Given by slow push OR
Midazolam 0.15mg/kg (Max 10mg)
Diazepam 0.25mg/kg (Max 10mg)
Achieve IV access or if seizure continues after 5 minutes and no IV access insert IO
10 min
5 min
Lorazepam 0.1mg/kg (Max 4mg )
Given by slow push OR
Midazolam 0.15mg/kg (Max 10mg)
Diazepam 0.25mg/kg (Max 10mg)
IV or IO Access
IM Midazolam 0.2mg (Max 10mg) OR
Buccal or Intranasal Midazolam 0.5mg/kg (Max 10mg)
2nd dose of Benzodiazepine given
10 minutes after IM/Buccal or IN route
5 min
IV or IO Access
2nd line agents
Phenytoin 20mg/kg over 20minutes (Max 1g) OR
Phenobarbitone 20mg/kg over 20minutes (Max 1g)
20 min
3rd line agents
Phenobarbitone 20mg/kg IV over 20minutes (Max 1g)
Sodium Valproate 30mg/kg over 10minutes (Max 1200mg)
Levetiracetam 40mg/kg IV over 5minutes (Max 3g)
If seizure continues after ONE 3rd line Agent OR AIRWAY Compromise at anytime
consider RSI in Consultation with SMO and ICU
Kidz First Emergency Care
Issued: 24/02/2014