Module 3: Assessment

Lesson 6

Status epilepticus: Comprehensive assessment (cont’d)

Physical examination

Within the first 5 minutes, the initial management strategy involves

• concurrent assessment and management of airway, breathing and circulation by securing the airway, administering O2;
• assessing vital signs;
• obtaining an intravenous access; and
• timing the seizure from its onset.

Neurologic examination of the patient should look for signs and symptoms of the underlying etiology, and particularly life-threatening conditions (e.g., meningitis, intracranial mass), in order to provide effective treatment.

In the emergent stage, a finger stick blood glucose reading should be obtained prior to initiating any initial pharmacological agents. For adults, if the glucose is < 3.3 mmol/L (60 mg/dL), IV administration of thiamine followed by D50W should commence (Glauser et al., 2015: Section 4)