One thing to remember, if a patient is suffering from chronic grand mal seizures, immediately treat the patient with IV lorazepam. If this does not work, try phenobarbital, if that does not work, immediately take an MRI/CT scan on the patient.
One of my patients had been suffering from chronic grand mal seizures, college-age female student. The patient came in the night prior while seizuring. Under the auspiece of the attendign MD, we had provided IV lorazepam. She stabilized.
Some couple of hours later, the same patient was seizuring again. Ka kulbaan ko kai we had given her IV lorazepam, it did not work. I ordered to give IV diazepam, did not work. I had ordered to give IV phenobarbital, still, not working. Patient coded on me. She went into VENTRICULAR TACHYCARDIA. At this time, I was really kulbaan. So, i took charge and immediately continued with ACLS procedure. Defibrillate the patient. Thank goodness we were able to bring her back.
Later on, after CT scan was done, we found out she had a minor subdural hematoma , that was causing and proliferating the grand mal seiures. The patient was taken to the OR , and the surgeons operated to correct the aneurysm. Had we not found this, she would have died.
Life, truly, is too fragile.
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