Emergency MedicineNeurology
Status Epilepticus (Adults)
Time-critical management of convulsive status epilepticus using the established benzodiazepine, phenytoin/levetiracetam, and anaesthetic escalation pathway.
Source: NICE CG137; ESEM guidelines; RCP Neurology Guidelines
Used in: Seizures & Epilepsy
Step 1 of ~9
warning
Recognise Status Epilepticus
Status epilepticus: seizure lasting >5 minutes OR two or more seizures without regaining consciousness.
IMMEDIATE ACTIONS:
• Time zero: note seizure start time
• ABCDE: airway positioning, O₂ 15 L/min non-rebreather
• IV access (or IO if IV unobtainable)
• Blood glucose STAT — treat if <4 mmol/L (thiamine 250 mg IV first if alcoholism/malnutrition)
• Blood: glucose, FBC, U&E, LFTs, AEDs levels, Ca²⁺, Mg²⁺, toxicology, ABG
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Phenytoin / Fosphenytoin · Antiepileptic — Status Epilepticus (Second-Line)
- Levetiracetam (IV) · Antiepileptic — Status Epilepticus (Second-Line)
- Levetiracetam IV (Status Epilepticus) · Antiepileptic — Second-Line Status Epilepticus
- Diazepam (Paediatric) · Benzodiazepine — Status Epilepticus / Febrile Convulsions (Community)
- Midazolam (Paediatric) · Benzodiazepine — Status Epilepticus (First-Line) / Procedural Sedation
- Propofol · Anaesthetic (IV Induction / Sedation)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
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