When do you intubate in status epilepticus?
Patients who fail to respond to benzodiazepine will frequently require intubation and sedative infusion to control their seizures. Early intubation in these patients may expedite seizure control and avoid complications. Propofol and ketamine are powerful anti-epileptic agents.
Why would you intubate a seizure patient?
In the emergency treatment of patients with generalized seizure, especially those with status epilepticus, tracheal intubation (TI) is sometimes required in order to secure the airway and support respiration (1).
Should you intubate a seizure patient?
Endotracheal intubation should only be attempted in those seizure patients who have prolonged respiratory depression or a respiratory arrest.
What is the treatment of choice for status epilepticus?
The benzodiazepines most commonly used to treat status epilepticus are diazepam (Valium), lorazepam (Ativan), and midazolam (Versed).
Does succinylcholine lower seizure threshold?
If seizures persist despite benzodiazepines, small doses of succinylcholine or another neuromuscular blocker should be considered to minimize the motor manifestations of seizures and reduce acidosis and hypoxemia [45].
What is the immediate IV treatment for status epilepticus?
Intravenous benzodiazepines-diazepam, midazolam or lorazepam and phenytoin are the first line drugs recommended for termination of seizures. Diazepam (or midazolam), thiopental and propofol infusion are useful for control of Refractory SE (RSE). Newer drugs are being investigated for use in SE.
What is the first line treatment and route of administration for status epilepticus?
Initial treatment of early status epilepticus (SE) with intravenous lorazepam or intramuscular midazolam is able to control seizures in 63–73 %; buccal midazolam may be an alternative whenever intravenous or intramuscular application of other benzodiazepines is not possible.
What are the indications of phenobarbital?
DOSAGE & INDICATIONS
- For the treatment of status epilepticus.
- For the maintenance treatment of all types of seizures, including but not limited to partial seizures, myoclonic seizures, tonic-clonic seizures, or neonatal seizures not responding to other anticonvulsants.
- For the short-term treatment of insomnia.
What is the difference between phenobarbital and pentobarbital?
Pentobarbital is often subject to comparison with phenobarbital, another barbiturate, in the use of refractory status epilepticus. Studies have found that pentobarbital is superior in that it has faster brain penetration and a shorter half-life, making it the treatment of choice.
What renders it desirable for intubation?
Succinylcholine has an onset of action in less than 60 s, and the action is not prolonged; thus, it is a desirable drug to aid intubation (6).