Procedure Management
These images provide a step-by-step management protocol for patients. Find out more about each step.
Management
On arrival in the ED:
- Check ABC
- Administer high-flow oxygen
- Measure blood glucose
Drug regime
- IV access: Lorazepam 0.1 mg/kg IV
- No IV access: Diazepam 0.5 mg/kg PR
Drug regime
- IV access: Lorazepam 0.1 mg/kg IV
- No IV access: Paraldehyde 0.4 ml/kg (in same volume of olive oil) PR
Management
- Request senior help, if not already present
- Consider intraosseous access, consider IV cutdown if IV access not already established
Drug regime
- Phenytoin 18 mg/kg IV OR phenobarbitone 20 mg/kg IV AND paraldehyde 0.4 ml/kg (in same volume of olive oil) PR if not already given.
Management
- Rapid sequence intubation
- Transfer to intensive therapy unit (ITU)
Drug regime
- Thiopental 4 mg/kg
- Lorazepam 0.1mg/kg – 4mg max dose , can be repeated after 10mins
- Consider cut down if IO not available (generally not performed anymore due to the availability of IO)
- Requesting senior help should probably be earlier than 10mins