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Status epilepticus — SCE Acute Medicine MCQ

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EasyAcute Neurological PresentationsStatus epilepticusSCE Acute Medicine

A 44-year-old man is assessed on the acute medical unit. He has continuous generalised tonic-clonic seizure activity for 7 minutes. Oxygen saturation is falling and capillary glucose is normal. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: E — Give intravenous lorazepam and protect the airway

Give intravenous lorazepam and protect the airway is the best answer because ongoing convulsive seizure beyond 5 minutes is status epilepticus and needs benzodiazepine treatment with airway support. Commence fixed-rate intravenous insulin infusion is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Check glucose early, but do not delay benzodiazepine treatment.

Reference: NICE NG217; Resuscitation Council UK