Status Epilepticus: Refractory 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: Refractory Management Algorithm

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

Inclusion and exclusion criteria:

• Inclusion:
  • Patients > 1 month of age with:
    • Continuous or recurrent seizures lasting > 60 minutes -AND-
    • Located in ICU or ED care setting

• 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
• Blythe Duane, PharmD, BCPS | Clinical Pharmacist, PICU | Committee member
• Yong Han, MD | Critical Care Medicine | Committee member 
• Audrey Kennedy, PharmD, BCPS, CPPS | Clinical Pharmacy Specialist, Neurology | 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
• 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: 03/2025 
• Next expected revision date: 2028 

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