Seizure Protocol

2003年1月21日

A.   Pediatric: 1 à 2 à 3 à 4

1.      benzodiazepine: (a, b 兩者，任選一種)

a.       diazepam(valium), IV

neonate, 0.25mg/kg

infant & child, 0.1~0.5 mg/kg

q2~5 min, repeat x 2 times, if necessary

max dose:  < 5yr, 5 mg

                     >5 yr, 10 mg

b.      lorazepam (ativan) IV

neonate, 0.05 mg/kg

infant & child, 0.1 mg/kg

q2~5 min repeat x 2 times, if necessary

max dose: 4 mg

2.      phenobartital

          neonate, 25 ~ 30 mg/kg (rate < 2 mg/kg/min)

                  infant & child, 15~25 mg/kg

3.      phenytoin

  10~20 mg/kg (rate<0.5 mg/kg/min)

4. continuous infusion for status epilepticus:

a.       midazolam coma: 2.5 mcg/kg/min (range: 1 ~18)

b.      pentobarbital coma (pentothal, barbiturate coma): 0.5 ~5 mg/kg/hr

Maintain：Phenobarbital (IV, PO) 2.5 mg/kg bid

B. Adult: 由上而下，依序使用

Lorazepam 0.075 mg/kg (rate: 2 mg/min),

Immediately followed by phenytoin 20 mg/kg (rate £ 50mg/min)

If seizure continues, add phenytoin 5~10 mg/kg (rate £ 50mg/min)

If seizure continues, phenobarbital 20 mg/kg (rate: 50~100mg/min)

If seizure continues, add phenobarbital 5~10 mg/kg (rate:50~100 mg/min)

If seizure continues, benzodiazepine coma (midazolam : 1~18 mcg/kg/min) or barbiturate coma (pentobarbital: 0.5 ~5 mg/kg/hr)

Maintain： phenytoin: 100 mg q6~8 h