Paediatric seizures

the pre-alert

  • prehospital - how many doses of benzodiazepine? don't restart the count!

the arrival

  • past history of seizures
  • duration of current seizure

key mimics:

APLS

is time-based.
2 doses of benzodiazepine

  • 0.1mg/kg lorazepam IV/IO up to 4mg
  • 0.3mg/kg midazolam buccal up to 10mg
  • 0.15mg/kg midazolam IV/IO up to 10mg
    Repeat IV midaz or loraz

2nd line agent

  • levetiracetam 40mg/kg up to 3g over 5 min
  • Phenytoin 20 mg kg-1 IV (over 20 min with ECG monitoring) OR
  • Phenobarbital 20 mg kg-1 IV (over 5 min)
  • thio 4mg/kg or 1-1.5mg/kg propofol

#paeds #neurology #resuscitation

Febrile Convulsion