Do you give benzo's to a hypoglycemic seizure?

[1EMT-P]

For those of you who are interested there was an article in the August 1, 2003 edition of American Family Physician that covers the management of seizures.

In the article they mention that Lorazepam is the preferred first line drug of choice in treating seizures because of it's anticonvulsant action and the fact that it is long acting.

They also mention the fact that hypoglycemia may bring on status epilepticus and that the condition is quickly reversible when treated with 50 ML of 50% glucose. They also state that glucose should be given immediately if hypoglycemia is suspected.

[1EMT-P]

I have started IV's in seizing patients and I have watched other medics start IV's in seizing patients, so don't tell me that it is impossible to start an IV in a seizing patient.

I hope your not skipping IV's just because they are difficult!

[Asysin2leads]

Well EMT-P1, my feelings on this subject come not only from my own experiences with patients, but also from picking the brains of the senior medics I work with, some of whom have over 20 years of experience in the New York City EMS system. They're opinion on the matter is the same as mine, that in an actively seizing patient, give the IM injection, stop the seizure, then treat appropriately. Now if you want to tell these guys, who can start an IV on the ankle vein of an ODing junkie, that you believe that "They're doing it because IV's are difficult", go right ahead. Until then, from the bottom of my heart, stick your opinion where the rectal Valium goes.

[1EMT-P]

Asysin2leads,

Why are your medics starting IV's in ankle veins? Why not start an EJ or an IO? What if you need to give Adenosine or D50 to the patient?

PS: you'll feel better :!:

[Asysin2leads]

Because starting an EJ in the neck on someone who needs Narcan to start breathing again is excessive and needlessly places the patient in jeopardy. Adenosine is not indicated in an opiate overdose. Neither is D50. It was a hyperbole, but I guess it kinda went over your head. You sure showed me. :roll: Now do you really want to whip it out and see who is bigger, or can you just accept the fact that maybe, just MAYBE you don't know everything? Really though, thanks for the info on diabetics and benzodiazipines, because during paramedic class all I did was scratch my ass and pick my nose. Thank god your around to keep me in line.

[Ridryder 911]

Wow..! to think to do an I/O for D50W ...well that just proved a point...

Be safe,

RIdryder 911

[Ace844]

Hi All,

Hmmm... an IO for D50, eh!??!!??! :shock: Just curious, "1EMT-P", does this mean that the golden rule in medicine, 1st do no harm, doesn't apply to your EMS practice :?: :?: :?: :idea: :roll: :? :arrow:

Ace

[Ace844]

Hi All,

For those that are interested in a synopsis of the latest literature reviews and synopsis and treatments of status seizure as of 3/05 then please check out these links...

http://www.cochrane.org/reviews/en/ab001905.html

http://www.emedicine.com/emerg/topic554.htm

Hope this helps,

Ace844

[kevkei]

LMAO at the professionalism on this site.

[1EMT-P]

According to the Regional EMS Council of New York City (REMSCO) ALS Protocols you are supposed to do the following for a seizure patient.

1. BLS

2. Cardiac Monitoring

3. Start an IV/Saline Lock

4. Administer 25 gm of 50% Dextrose IV.

5. Administer Lorazepam 2 mg IV or IM if IV access is not available.

What I told you was not wrong, it was correct... I would highly suggest that you review your protocols and that you follow them. If you go outside of your protocols and something happens a good lawyer will say that you were practicing medicine without a license!