Status Epilepticus: The Daily PANCE Blueprint

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Status Epilepticus: The Daily PANCE Blueprint

A 22-year-old female with an unknown past medical history presents to the ER with a prolonged seizure lasting more than 5 minutes per EMS. Her airway was supported and IV access was obtained en route to the ER. Her blood glucose is 120. Her vitals are stable and laboratory studies are relatively unremarkable. Which of the following would be an appropriate medication to give to this patient?

A. Calcium gluconate
B. Propofol infusion
C. Lorazepam
D. Clonidine
E. Narcan

Answer and topic summary

The answer is C. Lorazepam

The patient has status epilepticus, which is defined as >5 minutes of continuous seizures or > 2 discrete seizures between which there is incomplete recovery of consciousness. Most episodes of status epilepticus in adults are due to a brain lesion or a toxic/metabolic disturbance (e.g., alcohol withdrawal, hypoglycemia, etc). Immediate management of status epilepticus includes stabilizing the airway, placing pulse oximetry and cardiorespiratory monitors, establishing IV access, and getting a glucose level. The first-line pharmacological agent given is a benzodiazepine (e.g., lorazepam or diazepam). Keppra, valproate, or other anti-seizure medication can be given as well.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Neurology ⇒ Seizure disorders ⇒ Status epilepticus

Also covered as part of the Internal Medicine EOR and Emergency Medicine EOR topic list