Seizures and Fever (cont.)
Should the child come to the hospital with persistent seizure activity (what is termed status epilepticus), the following interventions will be undertaken in the emergency department:
- Emergency treatment is begun to make sure the airway is open and oxygen intake is adequate. A monitor called a pulse oximeter will be used to measure oxygen content in the bloodstream. If additional oxygen is needed, a mask may be used.
- If necessary, the airway may be opened by means of a jaw thrust, chin lift, or a device known as an oral airway. In some cases, it may be necessary to breathe for the child, either with the use of a bag and mask or by placement of a tube in the trachea (windpipe).
- Additional interventions may be needed as a physical examination is performed.
- Placement of an IV line to obtain blood for testing and to administer medication to stop the seizure
- A rapid bedside test for blood sugar (glucose) to determine if it is low and if glucose needs to be given through the IV (low blood sugar can cause seizures)
- Measuring vital signs (temperature, pulse, respiratory rate, and blood pressure)
- Treatment to lower body temperature, if fever is present
benzodiazepines, such as lorazepam (Ativan) or diazepam (Valium). Sometimes more than one dose or more than one type of medication is needed.
The medications used often cause sedation. Combined with the natural drowsy state after a seizure, the child may remain sleepy for quite some time afterward.
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
Thomas Rebbecchi, MD, FAAEM
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