Inclusion: Adult ≥ 18 with generalized convulsive seizures
Exclusion:
Pediatrics
Complex partial seizures
Acute head trauma
Multi-system trauma
Brain mass or tumor
Immunocompromised patients
Eclampsia.
Level A:
Administer additional antiepileptic medication in refractory status epilepticus who have failed treatment with BZDs
Level B:
Administer IV phenytoin, fosphenytoin, or valproate in refractory status epilepticus who have failed BZD
Level C:
EP need not initiate antiepileptic medication in ED for 1st time provoked seizure. Identify and treat precipitating medical conditions.
EP need not initiate antiepileptic medication in ED for 1st time unprovoked seizure with out evidence of brain disease or injury.
EP may initiate antiepileptic medication in ED or defer in coordination with other providers, for patients who experienced 1st unprovoked seizure w a remote history of brain disease or injury.
Do not need to admit patients with 1st unprovoked seizure who have returned to clinical baseline in Ed.
When resuming antiepileptic medication in ED is deemed appropriate, EP may administer IV or oral medication at their discretion.
Administer IV levitiracetam, propofol or barbiturates in refractory status epilepticus who failed BZD
Pediatrics
Complex partial seizures
Acute head trauma
Multi-system trauma
Brain mass or tumor
Immunocompromised patients
Eclampsia.
Administer additional antiepileptic medication in refractory status epilepticus who have failed treatment with BZDs
Administer IV phenytoin, fosphenytoin, or valproate in refractory status epilepticus who have failed BZD
EP need not initiate antiepileptic medication in ED for 1st time provoked seizure. Identify and treat precipitating medical conditions.
EP need not initiate antiepileptic medication in ED for 1st time unprovoked seizure with out evidence of brain disease or injury.
EP may initiate antiepileptic medication in ED or defer in coordination with other providers, for patients who experienced 1st unprovoked seizure w a remote history of brain disease or injury.
Do not need to admit patients with 1st unprovoked seizure who have returned to clinical baseline in Ed.
When resuming antiepileptic medication in ED is deemed appropriate, EP may administer IV or oral medication at their discretion.
Administer IV levitiracetam, propofol or barbiturates in refractory status epilepticus who failed BZD
ACEP clinical policies
Sign out tools
Reexamination sample documentation
Mass casualty incident triage
STOPP/START criteria
Denver screening criteria
Critical care documentation
Clinical decision rules list