MedBugs: SAQ #551

Case: Infant status epilepticus

It is 11pm in your tertiary mixed emergency department and a 4-month-old baby arrives via ambulance with a generalised tonic-clonic seizure. Paramedics report that the child has been seizing ‘on and off’ for the last 30 minutes but have never regained consciousness.

Vital Signs on arrival are:

HR	188 bpm
RR	42 /min
Sats	89 % on RA
BP	102/53 mmHg
Temp	36.6 °C
Weight	7 kg

1. State (4) immediate management priorities, including details or doses where appropriate, for this patient. 4 marks

Despite your initial therapies, the child continues to seize and is now hypoventilating. You elect to intubate and organise a CT scan.

2. List (4) findings on the axial plane image shown. 4 marks

3. State (5) points on how you would assess for the underlying cause of the above findings. 5 marks

You refer your patient to neurosurgery and theatre will be ready in 30 minutes.

4. State (5) points on how you would manage this patient to optimise their clinical condition awaiting transfer to theatre 5 marks

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Case: Infant status epilepticus

1. State (4) immediate management priorities, including details or doses where appropriate, for this patient. 4 marks

2. List (4) findings on the axial plane image shown. 4 marks

3. State (5) points on how you would assess for the underlying cause of the above findings. 5 marks

4. State (5) points on how you would manage this patient to optimise their clinical condition awaiting transfer to theatre 5 marks

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