Status Epilepticus: Initial Management

Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members. 

Clinical Pathway: 

• Status Epilepticus: Initial Management Algorithm 
• Status Epilepticus: Initial Management Synopsis (provides care standards employed for this clinical pathway) 

Inclusion and exclusion criteria: 

• Inclusion: 
  • Patients > 1 month of age with: 
    • Seizure > 5 minute in duration  

-OR- 

• • • Recurrent seizures without return to baseline between episodes 
• Exclusion: 
  • Patients presenting after a seizure that is now resolved (refer to alternate Children’s Mercy clinical pathway, if applicable): 
    • Seizure: First, Non-Febrile 
    • Seizure: Febrile 

Committee members involved in the development: 

• Jessica Wallisch, MD | Critical Care Medicine | Committee Co-chair 
• Ara Hall, MD | Neurology | Committee Co-chair 
• Jacob Arends, MD | Neurology | Committee member  
• Sarah Brunner, MD | Critical Care Medicine | Committee member 
• Shelby Chesbro, MD | Pediatric Hospital Medicine Fellow | Committee member 
• Blythe Duane, PharmD, BCPS | Clinical Pharmacist, PICU | Committee member 
• Angela Etzenhouser, MD | Hospital Medicine | Committee member 
• Marcie Files, MD | Neurology | Committee member 
• Kathryn Jahnel, RN | Staff Nurse, 6 Henson | Committee member 
• Audrey Kennedy, PharmD, BCPS, CPPS | Clinical Pharmacy Specialist, Neurology | Committee member 
• Micala Kreighbaum, BSN, RN | Staff Nurse, 6 Henson | Committee member 
• Maria Newmaster, MD | Pediatric Fellow | Committee member 
• Sarah Nienhaus, BSN, RN, CPEN | Education Coordinator, Emergency Department | Committee member 
• Natalie Perrin, BSN, RN, CCRN | Critical Care Medicine | Committee member 
• Jay Rilinger, MD | Critical Care Medicine | Committee member 
• Erin Scott, DO | Emergency Medicine | Committee member 
• Noelle Tran, DO | Emergency Medicine and Child Abuse Fellow | Committee member 
• Lines Vargas Collado, MD | Neurology | Committee member 
• Jill Vickers, MSN, RN, NI-BC, CPN | Clinical Practice and Quality | Committee member 
• Xuexin Lu, MD | Critical Care Fellow | Committee member 

Patient/Family Committee Member: 

• Jeff Heinrich | Committee Member 

EBP Committee Members: 

• Todd Glenski, MD, MSHA, FASA | Anesthesiology, Evidence Based Practice 
• Kori Hess, PharmD | Evidence Based Practice 

Publication dates: 

• Finalized date: 07/2024 
• Next expected revision date: 2027 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.  

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.