During Active convulsion:

Put a spatula or wooden ruler, covered wit cloth (like handkerchief), between the teeth, to prevent tongue bites.

For immediate control of convulsions,

Give:

Inj.  Paraldehyde 5ml. deep IM in each buttock. (Use glass syringe 0.15ml/ kg) or

Inj.  CALMPOSE 2cc I.V. slowly. Repeat if necessary after 15 mins. (Diazepam=0.3mg/kg upto 12mg in 24 hours)

If not controlled:

Inj.  PHENYTOIN 100mg I.V. very slowly. Repeat if necessary after 10-15 mins. Or

Inj. Gardenal 2-4 ml IM (Phenobarbitone)

If the patient is a known epileptic, do not give any injection – except if convulsions are frequent or prolonged.

After the convulsions are controlled:

IF the patient is a known epileptic, nor investigations are required.

If the patient is not a known epileptic,

A new convulsions, esp. in the middle age or later, must be investigated fully with E.E.G and C.T. scan.

If there is H/o injury – X-ray skull and C.T.scan.

If patient has fever and headache L.P for meningitis.

If Pregnant or recently delivered, Check B.P. and urine albumen for Toxemia

If limbs are rigid in between convulsions of if lock jaw – Tetanus.

Don’t try to hold down a patient in convulsions with force, only see that he does not hurt himself.

If known epileptic, do not give anything. The convulsion will stop by itself. Give injections if it persists for more than 3-4 minutes.

Inj.  Paraldehyde