What protocols for the ED treatment of seizure/SE patients exist?
Very few protocols for the treatment of seizures and SE have been published or studied in a clinically robust manner. The VA cooperative study (Treiman, NEJM, 1998) utilized four treatment regimens in the only randomized study of SE, demonstrating that lorazepam, phenobarbital, and diazepam and phenytoin in combination all are equally effective in treating SE patients. This study demonstrates the fact that any antiepileptic drug, when used quickly and in adequate mg/kg doses, will terminate most episodes of SE. What do these SE protocols tell us about ED therapies and treatment timing? Most SE protocols that have been published or are available on internet websites suggest the following: When evaluating and treating patient with prolonged seizures and SE, it is important to quickly manage the airway and vital signs, check for hypoglycemia, and initiate therapy in a matter of minutes. With tens of minutes, patient should receive one or more antiepileptic drugs (AEDs), which should be fu
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