Short Attention Span Summary
IV access is hard in seizing patients
Prolonged, uncontrolled seizures harm the brain by damaging neurons. This systematic review of 11 studies found non-IV benzodiazepines (NIVB) were able to be given more quickly than IV benzos and stopped seizure activity over 3 minutes sooner. Overall treatment failure was lower for NIVB, but failure rates were the same in the subset of pediatric patients. Complication rates were no different between the two. NIVB were given by rectal, buccal, intranasal, or IM route.
If there is any delay in obtaining IV access, give benzodiazepines by a non-IV route to control seizure activity faster. JWatch has a free summary of this article as well.
Intravenous versus Non-Intravenous Benzodiazepines for the Abortion of Seizures: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Acad Emerg Med. 2017 Mar 25. doi: 10.1111/acem.13190. [Epub ahead of print]