Benzodiazepine Dosing for Status Epilepticus in Emergency Departments

In a multicenter trial, initial doses of benzodiazepines for status epilepticus were frequently below guideline recommendations, especially for lorazepam and midazolam.

Although rapid control of seizure activity is associated with improved outcomes in status epilepticus, a recent study of emergency medical service protocols in California found that few recommended guideline-endorsed doses of benzodiazepines (NEJM JW Emerg Med May 2019 and JAMA 2019; 321:126). Despite the established safety of larger doses of benzodiazepines, prehospital providers or agencies may shy away from them for fear of respiratory depression. To assess dosing at emergency departments (EDs), which are well-equipped to handle this complication, researchers conducted a secondary analysis of data from a multicenter trial of patients with status epilepticus who failed to respond to benzodiazepines.

Among 102 patients who received their fi…

Reviewing Author

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Benzodiazepine Dosing for Status Epilepticus in Emergency Departments

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Reviewing Author