PulmCrit (EMCrit)
PulmCrit - May 8, 2017 - By Josh Farkas
- "Ongoing generalized convulsive seizures are an immediate life-threat that may cause brain damage, aspiration, rhabdomyolysis, hyperkalemia, arrhythmia, and hyperthermia.
- A streamlined algorithm is proposed to achieve rapid seizure control using immediately available medications.
- 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. Emerging evidence suggests that they work synergistically by affecting GABA and NMDA receptors, respectively.
- The best conventional anti-epileptic agent is unknown and currently under investigation in the ESSET trial. Fosphenytoin has the most side-effects, so for now evtiracetam or valproic acid seem like the best choices."
