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Coma

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Clinical features
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Immediate management

Give lorazepam a   0.1 mg/kg iv at 2 mg/min 

Why?

  • It is faster than diazepam, phenobarbital (10 minutes faster) or phenytoin (25 minutes faster) at terminating seizures a
  • It is better than phenytoin at terminating seizures, but is not clearly different than diazepam with or without phenytoin, or phenobarbital d


Lorazepam is stops more seizures than phenytoin

Patient Treatment Comparison Outcome CER RRR
(95% CI)
NNT
(95% CI)
status epilepticus a lorazepam phenytoin termination of seizures
at 60 minutes
42% 29%
(1% to 64%)
8
(4 to 160)

Expiry date: September 2003
Levels of Evidence used in grading these guides

Authors   W   Whiteley , CM   Ball
Reviewer   M   Daniel
CAT Writers   W   Whiteley , CM   Ball