The majority of seizures will be self-limiting and will cease spontaneously within five minutes. Seizures persisting beyond five minutes should be treated as SE
Failure to treat patients with convulsions on the basis that they may actually represent pseudo-seizures. It represents a far greater danger to fail to treat a patient who may have genuine SE than it does to assume the seizure is functional rather than organic
Leaving too short a time for an agent to have its effect before instituting treatment with a further agent. This may compound any adverse effects. For patients with impending SE, 10 minutes should be allowed between subsequent drug doses
Prescribing intravenous sodium bicarbonate for patients in SE with a profound metabolic acidosis. This acidosis will usually resolve spontaneously and may contribute to the cessation of convulsions.
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