Question
A well 6-year-old child is brought convulsing to an emergency department without any prior history of fever. Which of the following steps would be of prime importance in managing this child?
| A. |
Airway, breathing and circulation (ABC) assessed + intravenous midazolam
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| B. |
ABC assessed + intravenous fosphenytoin
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| C. |
ABC assessed + intravenous valproate
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| D. |
Intubate the child + intravenous levetiracetam
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Show Answer
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Correct Answer � A
Explanation
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Ans. A. Airway, breathing and circulation (ABC) assessed + intravenous midazolam
Revised ILAE ( international league against epilepsy)defines any seizure (generalized)lasting longer than 5 mins ( referred to as t1) as status epilepticus. For focal seizures and with impaired consciousness ( previously referred to as complex partial seizures)and absence seizure, the t1 is 10 min
The first step in the management of a child in SE is a quick examination and few rapid blood tests (glucose, calcium,sodium, potassium etc)
Soon after that, aborting the ongoing seizure with a parenteral short-acting benzodiazepine is recommended ( midazolam, lorazepam, diazepam). And if seizures persist even after the second dose of BZP, agents like fosphenytoin, phenytoin, levetiracetam can be used.
Refractory and super refractory SE may need agents like general anesthetics, continuous midazolam infusions.
