Therapy

Get help. ^d

Check airway, breathing, circulation. ^a

Give 

• oxygen ^b  
• lorazepam ^a  0.1 mg/kg iv at 2 mg/min
• or diazepam ^a  0.15 mg/kg iv at 5 mg/min
  An alternative route is rectally; using larger doses ^a  

Fits often continue. ^b  If they do, try

• phenobarbital ^a 15 mg/kg iv at 100 mg/min

• phenytoin ^c  18 mg/kg iv at 50 mg/min
  

• propofol ^c  
• midazolam ^d 
• thiopental ^d
  

On recovery, fully conscious patients not on medication can be rapidly loaded with oral phenytoin (try 18 mg/kg). ^c