New Seizure or Breakthrough Seizure admission

Patient might have a witnessed seizure or was found unconscious by family with tongue bite, Bladder/bowel incontinence.

EMS:

Checks Blood sugar

IV line and IV Fluids

ER:

Routine Labs, Blood Cultures if infection suspected

Oxygen

IV Fluids

IV Ativan 2mg PRN seizure

CT Head with out contrast

Phenytoin/Fosphenytoin IV loading dose of 15-20mg/Kg x 1 dose

Patient goes to the ICU for Status Epilepticus

Hospitalist:

Telemetry

Ask if patient is compliant or not with medications

Stop offending medications like Tramadol

Neuro-monitoring q 4hrs

NPO if altered mental status

Fall / Seizure / Aspiration precautions

UA, Urine Toxicology

Target treatment for possible cause of seizures-alcohol withdrawal, BZD withdrawal

Neurology evaluation-? LP

Dilantin/Valproic level if patient had break-through seizures while on treatment

MRI of Head for first time seizures

EEG if mental status changes

Driving restriction-Enter Driving License details and Fax form to Department of Transportation.