Status Epilepticus Treatment Guide
Stepwise medication treatment protocols and dosage calculations
All medication doses are calculated in real-time.
Benzodiazepines are the drug of choice for first-line treatment. Choose one of the first 3 options, or consider alternative options if unavailable.
Lorazepam
(IV)Dosage
0.1mg/kg × 70kg = 7mg → 4mg (max dose applied)
4mg (max dose)
0.1 mg/kg IV (max 4mg/dose)
Administration
Administer slowly over 2-5 minutes. May repeat every 5-10 minutes.
📝 Key Notes
Most recommended first-line treatment. Long half-life reduces recurrence risk.
Midazolam
(IM)Dosage
0.2mg/kg × 70kg = 14mg → 10mg (max dose applied)
10mg (max dose)
0.2mg/kg IM (max 10mg)
Administration
Administer intramuscularly immediately when IV access is difficult
📝 Key Notes
The RAMPART study demonstrated faster administration and more effective outcomes than IV Lorazepam in prehospital settings.
Diazepam
(IV)Dosage
0.15mg/kg × 70kg = 10.5mg → 10mg (max dose applied)
10mg (max dose)
0.15-0.2mg/kg IV (max 10mg/dose), may repeat once after 5 min
Administration
Administer at a rate of 2-5mg per minute
📝 Key Notes
High lipophilicity allows rapid onset but quick brain redistribution results in short duration of action. Risk of recurrence.
Diazepam (Rectal)
(PR)Dosage
0.2mg/kg × 70kg = 14mg
14mg
2-6y: 0.5mg/kg (max 20mg), 6-12y: 0.3mg/kg (max 20mg), ≥12y: 0.2mg/kg (max 20mg)
Administration
Rectal gel or liquid formulation. Use when IV access is difficult
📝 Key Notes
📍 Level A alternative. Useful when IV access is difficult. Absorption may be inconsistent.
Phenobarbital
(IV)Dosage
15mg/kg × 70kg = 1050mg → 1000mg (max dose applied)
1000mg (max dose)
15-20mg/kg IV (max 1000mg)
Administration
Infuse at 50-100mg per minute. Monitor for respiratory depression
📝 Key Notes
📍 Level A/B alternative. Use when benzodiazepines and standard second-line treatments fail. Long-acting.