Yes! This patient has generalized convulsive status epilepticus. This is a neurologic emergency. You'll continue managing the airway by positioning them and providing suction, but you must treat his status epilepticus with the first-line therapy: benzodiazepines. Specifically, you need to give IV lorazepam or IM midazolam. This patient already has IV access, so we can do the former. The total dose to give should be 0.1mg/kg of lorazepam. However, we do know that it's possible to give too much. We don't want to have to intubate if we can help it, and if we treat this with the correct dose of benzodiazepines, he should get better and intubation can be avoided. The argument is always whether or not the risk of airway compromise is higher with ongoing status epilepticus (obviously a problem) or with excessive dosing that would necessitate intubation when it could otherwise be avoided (intubation is not a low-risk procedure). So, a 4mg dose here is reasonable, and we can repeat this to reach this target dose if needed.
You might be asking why we're doing this at 3 minutes, when part of the definition of status epilepticus is that it's been going on for ≥ 5 minutes. At this time point, if it was going to end, it would've done so already, and so we should try not to be dogmatic about this number. Worst case scenario is that in the time it takes to draw it up and administer it, the seizure ends after this time point but before 5 minutes.
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