Principles and application of the management of convulsions

  Convulsions (convulsions) are common critical pediatric emergencies that refer to generalized and localized muscle motor convulsions caused by involuntary strong contractions of skeletal muscles. The EEG can be normal or abnormal during convulsions. Seizure: A sudden, brief, abnormal behavior with a beginning and an end, caused by excessive discharge of nerve cells in the brain; its clinical manifestations are various, convulsive or non-convulsive; the EEG has abnormal waveforms during seizures.  Prevent convulsive brain injury prevent prolonged convulsions to intracranial hypertension, generative disorders treatment principles: 1, maintain vital functions 2, drug control of convulsive seizures 3, the search for the cause of convulsions and treatment 4, prevention of recurrence of convulsions Convulsive first aid general treatment: lying flat, lateral head position to keep the airway unobstructed, with cyanosis to give oxygen close observation of vital signs, pupils, the will to establish intravenous access related symptomatic treatment: such as physical cooling  The application of anticonvulsant drugs: short-lived convulsive seizures remit naturally, without anticonvulsant drugs convulsive seizures lasting 2 to 3 minutes are not relieved (including the persistent state of convulsions), the need to use anticonvulsant drugs an anticonvulsant drug fails to control the seizure, you can repeat the application or switch to other anticonvulsant drugs can not repeat the same anticonvulsant drug many times in a row to avoid the accumulation of poisoning after the use of drugs still If the seizures persist, the presence of intracranial organic lesions, metabolic disease and poisoning must be considered.  Reasons for intravenous medication: Valium, clonidine, imipramine, lorazepam, sodium valproate, phenytoin sodium, thiopental sodium, etc. Intramuscular medication: luminal (phenobarbital), lorazepam, clonidine, imipramine, etc. Gastrointestinal route medication: chloral hydrate, valium suppositories or injections Inhalation medication: trichlorobromoethane Special note: If the convulsions persist after half an hour of treatment as above, it is necessary to enter the If the convulsions persist after half an hour of treatment, the child must be admitted to the intensive care unit, intubated, and given general anesthetics such as pentobarbital and sodium thiopental, etc. Precautions for the use of anti-convulsants: The speed of intravenous injection should be slow. /Although the effect of this drug is slower, but the duration of action is longer, the combination of the two drugs to complement the shortage, can achieve a better anti-stunning effect, especially for children with frequent convulsions.  However, the first luminal, especially intramuscular injection of luminal 20 ~ 60 minutes, the brain to reach the peak of the effective concentration, at this time should not use Valium and other drugs, otherwise, will aggravate the respiratory and cardiovascular depression.