Get IV access, or if not successful after 2 attempts, place an IO. Address the ABCs, check the sugar, and give benzodiazepines. The initial management of this child is status epilepticus should follow your normal approach to seizures. Could this be an isoniazid overdose? The child is still in an active tonic-clonic seizure as the paramedics transfer him to the resuscitation bay stretcher…
Apparently grandma is being treated for tuberculosis, and the pills were all over the ground. You are feeling very confident, but when paramedics role through the door, you encounter a mother screaming about her child being poisoned. You gather all the necessary pediatric equipment and have the broselow tape ready. You gather your team and perform a quick pre-brief, reviewing everyone’s expected role, the algorithm you will follow, and the anticipated pediatric doses. You get a patch from an EMS crew on route with a 3 year old boy in status epilepticus, with 5 minutes of tonic clonic seizure activity unresponsive to the first dose of midazolam.
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