A 6-year-old female with a history of seizures is actively seizing for 3 minutes. What should be administered once IV access is established?

In the case of a child actively seizing, the priority treatment is to administer a benzodiazepine once intravenous (IV) access has been established. Benzodiazepines, such as lorazepam or diazepam, are commonly used in emergency settings to rapidly control seizures due to their quick onset of action. They act by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, leading to a sedative effect that helps stop the seizure activity.

It's crucial to manage prolonged seizures effectively, as they can lead to increased risk of complications, including status epilepticus, which requires immediate pharmacological intervention. The choice of a benzodiazepine in this scenario reflects the standard emergency protocols for seizure management in pediatric patients.

Other treatments, such as glucose solutions, may be necessary depending on the patient’s blood glucose levels, but in the acute management of a seizure, the immediate goal is to halt the seizure with a benzodiazepine. Similarly, narcotic analgesics are not indicated for seizure management and could potentially exacerbate respiratory depression. Oral anticonvulsants are generally used for long-term management but are not appropriate for the urgent situation presented when a child is actively seizing.