Seizure

🔑 Key Priorities

• Protect airway and stop seizure activity promptly

• Identify and treat underlying cause

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🧠 Team Actions

Role	Task
Team Leader	Guide timeline and escalation
Airway Manager	Protect airway, provide O₂ ± intubate
Circulation	Gain IV access, administer anticonvulsants

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🧭 Management Algorithm

1. Time seizure: if > 5 min → status epilepticus

2. Protect from injury, give O₂, lateral position

3. First-line agents:

   • Adults: Midazolam 2–5 mg IV or buccal

   • Paediatrics: Midazolam 0.1–0.2 mg/kg IV or buccal (max 10 mg)

4. Second-line agents:

   • Adults: Levetiracetam 1–2 g IV or phenytoin 15–20 mg/kg IV

   • Paediatrics: Levetiracetam 40 mg/kg IV (max 2.5 g)

5. If still seizing: prepare for intubation and GA (propofol or thiopentone)

6. Investigate underlying cause: glucose, electrolytes, infection, trauma

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🔄 Ideal Crisis Flow

           Active or Prolonged Seizure
                    ↓
     Protect Airway + Lateral Position + O₂
                    ↓
     Midazolam ± Levetiracetam / Phenytoin
                    ↓
        Intubate if Ongoing + Treat Cause
                    ↓
              ICU ± Imaging / Labs