frist add management of epilepsy

Frist  add management  of epilepsy

Following step are taken

1]patient is put of lateral position to avoid falling back of tongue and aspiration of forth  

2]A rolled gauze piece or even handkerchief is put into mouth to avoid tongue bite .till mouth gag or oral airway is available one oral airway is produced then immediately suction is started .

3]one of the following drug regimen is started

A]inj pheobarbitone 200 mg diluted with 50ml of normal saline is given i.v slowly over 10 minutes this is repeated every half hr to the maximum 4 Gm/day

B] inj diazepam [valum 10 mg ]I v  state slowly within 2 minutes this is repeated after 10 minutes if convulsion continue then diazepam infusion is given add 100mg in IL of 5%DW and given at rate of 20drops/mint Beware of respiratory depression

C] phenytoin sodium [15 to20mg kg ] I v drip of [normal saline ] NOT dextrose ] 50mg/minut  it can also be given to the patient its maintained it rate of 100mg /6to8 hr as infusion if there is bradycardia or low blood pressure then do not use this drug .so ACG and BP monitoring it must

D] in resistant case inj thiopenton  1gm in 500 ml of ringer solution is given slowly as I v drip at rate of 1 ml/min