Status Epilepticus

Taming The SRU

Air Care Series: Status Epilepticus Update

Taming The SRU - By Goff Carl - August 17, 2020

"TAKE HOME POINTS:

• Generalized convulsive status epilepticus (GCSE) must be managed emergently as it is unlikely to spontaneously resolve and can result in permanent neurologic injury.
• Treatment should begin after 5 minutes of seizure activity with a goal for seizure resolution by 30 minutes.
• Subtle convulsive status epilepticus should be identified and treated in similar fashion to GCSE
• Treatment should include a stepwise approach beginning with benzodiazepines followed by an anti-epileptic drug (AED). Any one of three AEDs including levetiracetam, fosphenytoin and valproate may be used.
• Continuous infusion of anesthetic agents may be necessary and will require additional support including securing the airway.
• Ketamine has previously shown benefit in super refractory status epilepticus and may soon become a useful modality in the transport setting as an earlier intervention."