Round 9 (Seizure)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











The nurse brings back a young adult male from the lobby who is having a seizure…











Initial Vitals











* Temp 98.8* HR 90* RR 10* BP 120/80* O2 92%











Critical Actions











* Verbalize ABCs on a Critical Patient* Obtain Immediate Blood Glucose Level* Give Benzodiazepine* Initiate Workup of New-Onset Seizures* Give Pyridoxine (Vitamin B6)











Final Diagnosis











Isoniazid Toxicity











Tips and Tricks











When the patient is unable to provide history, attempt to obtain the information from external sources











Additional Reading











* Isoniazid toxicity overview (Life in the Fast Lane)* Basic approach to seizures (EM Clerkship)* Basic approach to status epilepticus (EM Clerkship)* Ketamine for refractory status epilepticus (PubMed)











Corrections











Ketamine not Keppra as potential induction agent for status epilepticus (32:40)