Status Epilepticus

A 38 year-old female presents actively seizing with EMS. She will fail to respond to repeat doses of IV benzodiazepines, and will require escalating medial management. Following phenytoin infusion, the patient will become hypotensive (because the phenytoin was given as a “push dose”, which the nurse will mention). The patient will then stop her GTC seizure, but will remain unresponsive with eye deviation. The team should recognize this as subclinical status, and proceed to intubate the patient.   The patient will continue to seize following phenobarbital and propofol infusion. Urgent consults to radiology and ICU should be made to expedite care out of the ED. The team will be expected to debrief the phenytoin medication error and disclose the error to the husband.