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When fits don’t stop: status epilepticus

 This is a serious medical emergency which needs trained medical intervention. In this condition, the person has nearly continuous seizures without a break and without regaining consciousness. If left untreated, some sufferers may die or suffer serious brain damage. If emergency medical care is not available, then you should try to avert death or serious complications in this way:

• Remove false teeth and ensure an open breathing passage by inserting a plastic airway.

• Inject 100 mg of thiamine followed by a solution of 50% glucose (dextrose) rapidly, intravenously.

• Inject diazepam, 10 mg slowly, intravenously (over about two minutes).

• Wait for about five minutes.

• If seizures continue, set up an intravenous saline drip.

• Give diazepam intravenously at the rate of 5 mg per minute up to a maximum of 20 mg or until the seizures stop, whichever is first.

• Keep a close watch on respiratory rate; at any sign of distressed breathing, stop giving diazepam.

• If seizures continue, give phenytoin intravenously at the rate of 50 mg per minute up to a maximum of 1000 mg.

• Once seizures stop, immediately seek specialist medical help.

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