Algorithm for the treatment of status epilepticus: a New Zealand perspective

It is important to note, however, that it is expected that subcutaneous home HC would be offered to patients with AI who are unlikely or unwilling to use i.m. HC, in an effort to prevent hypotension before they can access more definitive medical care. Indeed, an emergency physician should assess all patients who have received a subcutaneous injection at home to determine the need for ongoing HC (i.v./i.m.). In situations where an AC is diagnosed, subcutaneous HC cannot be used because active shock may be associated with poorer absorption of HC. Given the reluctance among patients to administer home intramuscular injections, together with the recurrent experience of prolonged delays in HC administration in the emergency setting, subcutaneous administration is preferable to the situation in which there is no HC given for an incipient AC. Hopefully, the consideration of these suggestions and an increased use of HC by medical staff may prevent AC events in patients with known AI and intercurrent illness.