Acute Convulsions in Children
Management of acute seizures follows a strictly prioritized protocol. The goal is to stabilize the child and terminate the seizure activity immediately.
1. ABC Management (Stabilization)
- A (Airway): Ensure patent airway; position on the side (recovery position) to prevent aspiration.
- B (Breathing): Administer high-flow oxygen; monitor pulse oximetry.
- C (Circulation): Establish IV access (or IO if IV failed); check blood glucose immediately (treat hypoglycemia).
2. Pharmacological Escalation
| Step | Drug of Choice | Route |
|---|---|---|
| First Line | Lorazepam or Diazepam | IV (or rectal Diazepam if no IV) |
| Second Line | Phenytoin or Levetiracetam | IV infusion |
| Third Line | Phenobarbitone or Midazolam drip | IV infusion (ICU setting) |
NEET PG Hint: Remember the definition of Status Epilepticus: a seizure lasting > 5 minutes or repeated seizures without regaining consciousness between episodes. Always rule out Hypoglycemia and Hypocalcemia as potentially reversible metabolic causes in any child presenting with a first-time acute convulsion.