Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
Stabilization priorities
Airway protection triggers
Persistent loss of protective reflexes
Recurrent convulsions without recovery
Refractory hypoxaemia or hypercapnia
Breathing support
SpO2 target 94-98%
Capnography for hypoventilation concern
Circulation support
IV access x2
Cardiac monitoring for dysrhythmia
Rapid reversible causes
Point-of-care glucose
Naloxone if opioid toxidrome
Ongoing seizure algorithm
Status epilepticus definition
Convulsive activity 5 minutes or longer
Recurrent seizures without baseline recovery
First-line benzodiazepine (Class I)
Lorazepam IV 0.1 mg/kg
Typical adult dose 4 mg
Repeat once after 5 minutes if ongoing
Midazolam IM 10 mg
Alternative when no IV access
Repeat 10 mg once after 10 minutes if ongoing
Second-line antiseizure loading (Class I)
Levetiracetam IV 60 mg/kg
Maximum 4500 mg
Infusion 10-15 minutes
Fosphenytoin IV 20 mg PE/kg
Maximum 1500 mg PE
Infusion rate up to 150 mg PE/min
Valproate IV 40 mg/kg
Maximum 3000 mg
Avoid in pregnancy and significant hepatic disease
Refractory convulsive status pathway
ICU escalation trigger
Persistent convulsions after benzodiazepine plus one second-line agent
Persistent coma or ventilatory failure
Continuous infusion options
Propofol infusion with ventilatory support
Midazolam infusion with ventilatory support
Time-critical “must not miss” conditions
Intracranial haemorrhage
Thunderclap headache
Anticoagulant use
CNS infection
Fever
Neck stiffness
Eclampsia
Pregnancy or postpartum
Hypertension with neurologic symptoms
Toxic ingestion or withdrawal
Alcohol withdrawal features
Sympathomimetic toxidrome
Immediate monitoring targets
Monitoring and targets
Neurologic trajectory
Time to return to baseline
Persistent focal deficit
Vitals and supportive care
Temperature trend
SBP target appropriate for suspected ICH pathway
Injury screening
Head trauma concern
Tongue laceration and aspiration risk
PEARLS
High-yield bedside rules
Ongoing convulsive activity at 5 minutes equals status pathway
Early benzodiazepine improves seizure termination likelihood
Delay increases ICU and intubation risk
First-time seizure equals “provoked vs unprovoked” decision point
Provoked seizure recurrence risk falls after cause corrected
Unprovoked seizure recurrence risk persists and guides follow-up and therapy
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.