Intraosseous and central venous blood biochemical and hemoglobin values were similar during hemodynamic stability and throughout 30 mins of resuscitation if no drugs were given through the intraosseous site. However, differences existed after 30 mins of CPR and infusions through the intraosseous site. Laboratory values may be erroneous when intraosseous blood is used during periods of resuscitation of >5 mins if drugs and fluid boluses have also been infused through the site. For reliable values, an intraosseous site for sampling only may be reasonable.
Status epilepticus is a serious medical emergency that requires prompt and appropriate intervention. Maintenance of adequate vital function with attention to airway, breathing, and circulation; prevention of systemic complications; and rapid termination of seizures must be coupled with investigating and treating any underlying cause. In most patients with SE, the use of adequate dosages of first-line antiepileptic agents allows for the successful and rapid termination of SE and avoidance of potential neurologic complications. Refractory SE requires more aggressive treatment, often the use of intravenous anesthetic agents and intense monitoring, and therefore must be managed in a pediatric intensive care unit with a multidisciplinary approach. Large, controlled, multicenter, comparative studies are needed urgently to clarify better the optimal management of these patients.
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