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You are transporting a 28-year-old male with a history of ep…

Posted byAnonymous June 15, 2021November 14, 2023

Questions

Yоu аre trаnspоrting а 28-year-оld male with a history of epileptic seizures to a tertiary care hospital with specialty neurosurgical capabilities. Earlier today, the patient sustained a prolonged seizure episode, during which he struck his head and sustained a subdural hemorrhage, which was confirmed on CT scan at the sending hospital. There was no evidence of intracranial shifting or mass effect. The patient's serial neurologic exams have been unchanged since departing the hospital. The patient has a GCS of 10 and the last vital signs were blood pressure, 132/78 mm Hg; heart rate, 82 beats/min; respirations, 18 breaths/min; SpO2, 99%. His pupils are PEARRL and 4 mm/brisk bilaterally. The sending hospital has mixed a Dilantin (phenytoin) IV drip at 50 mg/min, and it has just started infusing within the last 10 minutes. Suddenly, your patient draws a deep breath, contracts forcibly, and then begins to rapidly go through body-wide tonic–clonic contractions. You apply 100% oxygen, and a patent IV access is available. While contacting medical control for orders, you recall the use of IV Dilantin administration and you know that which of the following is a true statement?

Yоu аre trаnspоrting а 28-year-оld male with a history of epileptic seizures to a tertiary care hospital with specialty neurosurgical capabilities. Earlier today, the patient sustained a prolonged seizure episode, during which he struck his head and sustained a subdural hemorrhage, which was confirmed on CT scan at the sending hospital. There was no evidence of intracranial shifting or mass effect. The patient's serial neurologic exams have been unchanged since departing the hospital. The patient has a GCS of 10 and the last vital signs were blood pressure, 132/78 mm Hg; heart rate, 82 beats/min; respirations, 18 breaths/min; SpO2, 99%. His pupils are PEARRL and 4 mm/brisk bilaterally. The sending hospital has mixed a Dilantin (phenytoin) IV drip at 50 mg/min, and it has just started infusing within the last 10 minutes. Suddenly, your patient draws a deep breath, contracts forcibly, and then begins to rapidly go through body-wide tonic–clonic contractions. You apply 100% oxygen, and a patent IV access is available. While contacting medical control for orders, you recall the use of IV Dilantin administration and you know that which of the following is a true statement?

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