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Paediatric status epilepticus — RCPSC EM MCQ

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HardNeurological emergenciesPaediatric status epilepticusRCPSC EM

A 6-year-old remains convulsive five minutes after one adequate prehospital IM midazolam dose. IV access is now present, glucose is normal and ventilation is supported. What should happen next?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Give one full-dose IV lorazepam treatment and prepare a second-line antiseizure load

Explanation lettering: D = shown as A · E = shown as B · B = shown as D · A = shown as E

B is correct: one further adequate benzodiazepine dose is appropriate, while preparing second-line therapy if seizure persists. C exceeds two benzodiazepine doses and increases respiratory depression. D prematurely skips the second first-line dose. E delays treatment. A bypasses established second-line therapy and requires intensive-care airway control.

Reference: Canadian Paediatric Society, Emergency management of paediatric convulsive status epilepticus: https://cps.ca/en/documents/position/emergency-management-of-the-paediatric-patient-with-convulsive-status-epilepticus