Status Epilepticus Management

GGC Paediatric Guidelines
NHS GGC

Audience

This guidance for the management of status epilepticus is based on the new APLS guidance and has had some minor adaptions for use in RHCG agreed by all relevant stakeholders.

Guideline based on “Review of the new APLS guideline (2021): Management of the Convulsing Child” – see reference for original authors.

Advanced Paediatric Life Support (APLS) algorithm on management of the convulsing child

Download algorithm as pdf

Image of algorithm

Key updates with this revision

Step 1 & 2

►Shorter 5-minute interval between benzodiazepine doses.

►Pre-hospital treatment is endorsed.

Step 3

►Second line drug is levetiracetam (Keppra)

Step 4

►If the team are ready, they should proceed to RSI with either ketamine, thiopental or propofol.

►If the team are not ready either phenytoin or phenobarbital can be given and if immediately after completing this the child is still convulsing the team should proceed to RSI.

First line anti-seizure medications

Table detailing administration information for first line anti-seizure medications

Second line anti-seizure medications

Table detailing administration information for second line anti-seizure medications

Editorial Information

Last reviewed: 13/04/2022

Next review date: 13/04/2025

Author(s): Guideline based on “Review of the new APLS guideline (2021): Management of the Convulsing Child” – see reference for original authors..