I agree with Matt and Craig; if you do gases post-seizure you'll invariably
find profound metabolic acidosis. Stands to reason, all that muscular
hyperactivity together with insufficient oxygenation. I discourage my
juniors from doing gases post-seizure; it only makes them, and the medics,
panic and adds little to management. Respiratory compensation tends not to
occur during seizure because of tetanic muscle spasm, and tends to be
attenuated post-seizure because of the diazepam.
I agree Matt, acidosis per se is probably not such a bad thing after all
(though the causes of acidosis are a different matter). I'm sure it's
actually protective, it facilitates oxygen dissociation after all. I would
rarely reverse lactic acidosis using bicarbonate.
Adrian Fogarty
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