Assessment and Stabilization of Status Epilepticus in the Primary Care Office

Status epilepticus (SE) is a prolonged seizure episode. Prompt recognition and management of SE is essential in preventing morbidity and mortality associated with the condition. The longer SE persists the less responsive it becomes to first-line interventions. Additionally, a seizure episode that is longer than 30 minutes has increased risk of neuronal death and sequelae of SE. If the primary care clinician is confronted with a patient in SE, the evaluation and subsequent management should occur in a systematic, stepwise approach focusing on the patient's airway, breathing, circulation, and disability. Primary care clinicians and staff should be trained in supporting the pediatric airway, including the proper bag-valve-mask ventilation technique. Benzodiazepines are the first-line rescue medications for SE and should be promptly administered at the appropriate dose. [Pediatr Ann. 2025;54(7):e233-e237.].