Refractory Seizures in Children
You are in the role of an emergency service physician on the way to the patient - 4 years old boy Vitek who suffers from convulsions for approximately 20 minutes. According to the parents, the boy has had a fever over 38.5 °C since yesterday. An hour ago the temperature reached 39.3 °C in the axilla. The fever does not react to the administered dose of ibuprofen. You decide to administer 10 mg of diazepam via rectal access but the drug has only a temporary effect. During the transport to the children’s hospital the convulsions reappear.
How will you proceed?
EKG
rythm: sinus
action: regular
frequency: 110 bpm
Examination
A: airway clear
B: eupnoea 23 per min
C: circulation stable
D: full-body tonic-clonic convulsions without lateralization, no photoreaction
E: meningeal signs negative, skin without efflorescence
