After a suitable dose of rectal diazepam and time interval our local paeds
suggest rectal paraldehyde as next step or consider IV lorazepam-rectal
diazepam causes no further problem with iatrogenic apnoea
-----Original Message-----
From: Adrian Kerner <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 01 July 2000 00:34
Subject: Fitting one year old.
>Had a dilemma yesterday. What would you do?
>
>Large 12/12 old male.
>
>Immediately work. Sudden onset of fitting. Pyrexial.
>
>Given 5mg rectal diazemuls by paramedics( ~ 5 mins before arrival.) Still
>fitting in A&E.(35 min total). Airway difficult, but well pink with sats
>100%, on high flow O2. Reasonable ventilation.
>
>Otherwise cap refil normal, HR 190. BM normal.
>
>Anaesthetist called.
>
>Airway still maintained but still fitting.
>
>Gave very slow i.v.diazemuls to 2mg via running saline. Fit terminated.
>Child seen by anaesthetist and gradually needs BVM IPPV then ET. Wakes up
>after 60 min.
>
>Dilemma - how long do you wait for rectal Diazepam to work?
>Do you wait 5+ min whilst child is still fitting?
>
>Any answers on a post card.
>
>Adrian Kerner
>SpR A&E
>Leeds
>
>
>
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