A 55-year-old man is brought to the ED with a generalized tonic-clonic seizure that has continued for 8 minutes.
Vital Signs
HR
140/min
BP
160/90 mmHg
RR
Irregular
SpO2
89% on room air
Temp
37.5°C
Key Bedside Findings
Ongoing generalized convulsive activity for >5 minutes.
Airway protection and ventilation are impaired by the seizure.
Reversible precipitants—including hypoglycemia, electrolyte disorders, toxicologic causes, infection and acute structural brain disease—must be evaluated in parallel with seizure termination.
One dominant problem, clearer signals, immediate teaching feedback.
Learning targets
• Treat continuous convulsive seizure activity lasting 5 minutes or longer as status epilepticus.
• Stabilize oxygenation/airway and check point-of-care glucose without delaying adequate benzodiazepine treatment.
• Give an adequately dosed first-line benzodiazepine and repeat once when needed.
• Choose levetiracetam, fosphenytoin, or valproate for benzodiazepine-refractory convulsive SE according to patient-specific contraindications rather than claiming one is universally superior.