 |
 |
We have switched to lorazepam followed by a further dose followed by phenytoin infusion. If that does not stop the fitting general anaesthesia is indicated. Thiopentone is no longer a good choice, and propofol is much better. I don't understand Adrian Fogerty's concerns about oxygenation in GA; with RSI paralysis it is the optimum method for gaining control of the airway. There is a case for simply giving suxamethonium as the patient is unconscious from the fit and also from the benzodiazepine already given. Exasperatingly, the paediatricians seem wedded to rectal paraldehyde, which is ghastly and stinks department out for hours and patient out for days. Best wishes, Rowley Cottingham [log in to unmask]