Round 9 (Seizure)

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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)