Status epilepticus — DipIMC MCQ
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Correct answer: D — Give buccal midazolam or parenteral benzodiazepine according to local protocol
Give buccal midazolam or parenteral benzodiazepine according to local protocol is the best answer because a tonic-clonic seizure lasting over five minutes should be treated as status epilepticus. Give nebulised salbutamol as sole treatment is less appropriate because bronchodilator therapy may help wheeze but does not treat systemic shock; Give intramuscular adrenaline 1 mg is less appropriate because 1 mg intramuscular adrenaline is not the standard anaphylaxis dose. Give intravenous adrenaline 1 mg as a rapid bolus and Delay medication until hospital review are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.
Reference: JRCALC Guidelines; NICE Epilepsies guidance