Clinical scenario: 4-year-old male having a seizure

You are asked to respond to a residence for a report of a child seizing

"Engine 2443, respond priority 2 for a 4-year-old male. Caller states that her son was seizing for 10 minutes but has finally stopped."

You are met at the door by a man in his 30s who states that his son periodically has seizures. He leads you to a bedroom where his wife indicates that their son was taking a nap and was found actively seizing when she came in the bedroom after hearing a noise.

Your patient, Stephen, is lying on his back and appears to be unresponsive but is breathing normally. He does not appear to have fallen from the bed or experienced any other trauma during the seizure. Stephen’s mother states that he was born prematurely and, due to difficulties during delivery, suffered from an extended period of hypoxia at birth. Since then he has seizures on almost a weekly basis. Recently, however, his seizures have been increasing in length and frequency. Today the seizure lasted approximately 10 minutes before she gave his prescription dose of rectal diazepam.

Stephen’s vitals are:

  • B/P: 100/64
  • HR: 72
  • RR: 12
  • SpO2: 88%

Think about these questions as you consider what to do next:

  • What are some potential concerns about Stephen’s presentation?
  • How might your assessment be different based on his medical history?
  • What concerns do you have based on the medication he was given?

Post your answers below in the comments and view the clinical solution for this patient.

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