A Proposed Timeline for Status Epilepticus Patient Treatment

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A Proposed Timeline forStatus Epilepticus
Patient Treatment
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Edward P. Sloan, MD, MPHAssociate
ProfessorDepartment of Emergency
MedicineUniversity of Illinois College of
MedicineChicago, IL
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Attending PhysicianEmergency
MedicineUniversity of Illinois HospitalOur
Lady of the Resurrection HospitalChicago, IL
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Clinical Questions

• How rapidly can the initiation of AEDs be
  provided in the Emergency Department?
• How rapidly can the actively seizing patient be
  controlled in order to reduce morbidity and
  mortality?
• What is a reasonable standard of care for SE
  treatment in the ED?

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SE Protocol Timeline

• 0 - 20 min Initial Rx
• Benzodiazepines
• 20 - 40 min Phenytoins
• 40 - 65 min IV bolus medications
• 65 - 90 min IV infusions

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SE Protocol Timeline

• 0 - 20 min Benzodiazepines
• 20 - 40 min Phenytoins
• 40 - 65 min Phenobarbital
• Valproate
• 65 - 90 min Propofol
• Midazolam

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SE Recommendations

• Develop a SE protocol
• Make all therapies available in ED
• Dose in a full mg/kg basis
• Anticipate the use of the next Rx
• Watch the clock continually
• Document the timing of the Rx

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Questions?? Edward P. Sloan, MD,
MPHedsloan_at_uic.edu312 413 7490