Pediatric Status Epilepticus

This case was written by Dr. Brad Stebner.

Dr. Stebner is a PGY4 Emergency Medicine resident at the University of British Columbia. His interests include medical education and leadership, sports medicine, and health care administration. He is particularly interested in using simulation to evaluate system efficiency, crisis resource management, and interprofessional collaboration. He completed his BSc at Michigan Tech University while playing NCAA hockey and his MD at the University of Calgary.

WHY IT MATTERS

Pediatric status epilepticus is a well recognized emergency that anyone working in a pediatric or general emergency department needs to be prepared to manage. The “seizure clock” is an important time based escalation in therapy that is reinforced in this case and leads to safe and definitive management.

CLINICAL VIGNETTE

You receive a pre-notification for an 8-year-old male with known seizure disorder who will arrive in 5 minutes. He has been seizing for roughly 7 minutes now and has received 1 dose of intramuscular midazolam 5mg.

CASE SUMMARY

Pre-notification is sent about an 8-year-old with known seizure disorder coming in via EMS who has been seizing for 7 minutes and is persistently seizing despite intramuscular midazolam. The case will involve managing pediatric status epilepticus and including escalating anti-epileptics, intubation, and handing over to pediatrics.

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