In the ED, their vitals/exam are as above. Most likely prolonged postictal state versus nonconvulsive seizures. Ddx also includes infection, such as UTI, PNA. May be due to intercranial process. May be due to a cardiopulmonary process. May be due to electrolyte abnormalities such as hypoglycemia, hyperglycemia, hyponatremia, hypernatremia, hypokalemia, uremia. May be due to intoxication/overdose. Lower suspicion for elevated ammonia, CO, and TSH.
– Labs: POCT glucose, VBG, lactate, CBC, CMP, Lipase, TSH, Coags, T&S, AED levels, UA, UCx, Ethanol, UTox
– Imaging: CXR, CTH.
– Treatments: IVF, AEDs, Consider O2/Head of bed to 30 degrees as needed
– Consults: Neuro, NSGY if potentially interveneable surgical process discovered on CTH
– Dispo: Likely admission to Neurology