Barnard College Columbia University Logo

As of 2012 Barnard pays Columbia about $5 million a year under the terms of the "interoperate relationship", which the two schools renegotiate every 15 years. Despite the affiliation Barnard is legally and financially separate from Columbia, with an independent faculty and board of trustees. It is responsible for its own separate admissions, health, security, guidance and placement services, and has its own alumnae association.

Nonetheless, Barnard students participate in the academic, social, athletic and extracurricular life of the broader University community on a reciprocal basis. The affiliation permits the two schools to share some academic resources; for example, only Barnard has an urban studies department, and only Columbia has a computer science department. Barnard students and faculty are represented in the University Senate, and student organizations such as the Columbia Daily Spectator are open to all students. Barnard students play on Columbia athletics teams, and Barnard uses Columbia email, telephone and network services. Barnard College aims to provide the highest-quality liberal arts education to promising and high-achieving young women, offering the unparalleled advantages of an outstanding residential college in partnership with a major research university.

With a dedicated faculty of scholars distinguished in their respective fields, Barnard is a community of accessible teachers and engaged students who participate together in intellectual risk-taking and discovery. Barnard students develop the intellectual resources to take advantage of opportunities as new fields, new ideas, and new technologies emerge. They graduate prepared to lead lives that are professionally satisfying and successful, personally fulfilling, and enriched by a love of learning.

Barnard College, one of the Seven Sisters schools, was founded in 1889 ; it remains an undergraduate liberal arts school for women only. The college was named for Columbia's 10th president, Frederick Barnard, whose campaign to have women admitted to Columbia resulted in a Collegiate Course for Women in the early 1880s. Women completing the curriculum were awarded a diploma from Columbia, but they had to pursue their courses of study independently. The program was soon abandoned, leading to the establishment of Barnard.

The college moved to its present location, across the street from Columbia in the Morningside Heights section of Manhattan, in 1898. Barnard College Of Columbia University Logo is one of the clipart about university of alabama logo clip art,mississippi state university logo clip art,university logo clipart. You can download Barnard College Of Columbia University Logo png clip art for free. Also, find more png clipart about school clipart,vintage clip art,college clipart. Barnard College is a liberal arts college for women located at 117th Street and Broadway next to Columbia's Morningside Heights campus.

It was founded in 1889 for female undergraduate students at a time when Columbia College was an all-male college. Barnard is located just across Broadway from Columbia University's main campus and is one of four undergraduate schools of the University . At the same time, as an independent college, Barnard maintains its own campus, faculty, administration, trustees, operating budget and endowment, while Barnard students earn the degree of the University. Since 1900, Barnard's inter-corporate agreement with Columbia has allowed both campuses to grow together, with distinct approaches, campus cultures, and communities in addition to nearly unlimited resources and extra- and co-curricular opportunities. Look for opportunities that complement one another between the two campuses.

Columbia University, major private institution of higher education in New York, New York, U.S. It is one of the Ivy League schools. Founded in 1754 as King's College, it was renamed Columbia College when it reopened in 1784 after the American Revolution. Columbia College was the undergraduate liberal arts school for men until 1983, when women began to be admitted. Besides Columbia College, the university includes two other undergraduate schools and the affiliated Barnard and Teachers colleges. Forbes ranked Barnard the 19th best liberal arts college in 2019, which also ranked it 50th among 650 universities, liberal arts colleges and service academies. Barnard College is a private institution situated in New York City, US. It was established in 1889 and since then the college has been providing stellar liberal arts education for women.

The college offers a number of Bachelor of Arts degree programs in more than 50 areas of study. These include several undergraduate programs in education, architecture, theater, dance, as well as urban studies. In March 1968, The New York Times ran an article on students who cohabited, identifying one of the persons they interviewed as a student at Barnard College from New Hampshire named "Susan". Barnard officials searched their records for women from New Hampshire and were able to determine that "Susan" was the pseudonym of a student who was living with her boyfriend, a student at Columbia University.

She was called before Barnard's student-faculty administration judicial committee, where she faced the possibility of expulsion. A student protest included a petition signed by 300 other Barnard women, admitting that they too had broken the regulations against cohabitating. The judicial committee reached a compromise and the student was allowed to remain in school, but was denied use of the college cafeteria and barred from all social activities. Except for Columbia College, by the 1940s other undergraduate and graduate divisions of Columbia University admitted women. Columbia president William J. McGill predicted in 1970 that Barnard College and Columbia College would merge within five years.

The 1973–1976 chairwoman of the board at Barnard, Eleanor Thomas Elliott, led the resistance to this takeover. The college's marketing emphasized the Columbia relationship, however, the Bulletin in 1976 stating that Barnard described it as identical to the one between Harvard College and Radcliffe College ("who are merged in practically everything but name at this point"). Smith and Columbia president Seth Low worked to open Columbia classes to Barnard students. By 1900 they could attend Columbia classes in philosophy, political science, and several scientific fields. That year Barnard formalized an affiliation with the university which made available to its students the instruction and facilities of Columbia. Franz Boas, who taught at both Columbia and Barnard in the early 1900s, was among those faculty members who reportedly found Barnard students superior to their male Columbia counterparts.

From 1955 Columbia and Barnard students could register for the other school's classes with the permission of the instructor; from 1973 no permission was needed. Barnard's president said the school is forming a safety group to serve as a forum for dialogue between public safety officers and supervisors and the Barnard community. It will be led by the school's executive director of equity and will include students, faculty, staff, along with outside expertise as needed. Columbia/Barnard Hillel Onward Israel is an immersive internship program offering resume building placements in a wide variety of opportunities in the greater Tel Aviv Area. This opportunity stretches to a variety of different internship placements and allows students to develop their professional future, gain international work experience, and build their resume through a high-level internship in the field of their choice.

Students spend their time on the program living, experiencing, and interning in Israel. This 8-week program places students in an internship based on their skills, interests, and future plans. Barnard offers courses in around 50 areas of study, primarily relating to the arts.

However joint programmes within science exist when in conjunction with other universities. The most popular subjects on offer at the college are english, psychology, political science, economics, history, and biology. Barnard College has a good number of infrastructures within its campus. These include lecture rooms, seminar rooms, laboratories and workshop as well as other faculty buildings.

In addition, there is the LeFrak Center which houses a study space, the zine collection, librarians' offices, course reserves. The college has a standard library situated in a serene environment. The Barnard Library houses a large collection of books, journals, archives, and other published materials. The library serves as a repository of several official and student photographs, publications, artworks, among others. Barnard College of Columbia University is a private women's liberal arts college in New York City.

It was founded in 1889 by Annie Nathan Meyer as a response to Columbia University's refusal to admit women and is named after Columbia's 10th president, Frederick Barnard. Barnard's pre-history dates back to 1876, the first time the Trustees of Columbia were petitioned to admit women. Beginning in 1886, the trustees would begin offering an actual Columbia BA degree to course completers. Barnard College, based in New York City, was founded in 1889 in response to Columbia University's then-refusal to admit women onto academic programmes.

Today, it stands as one of the oldest women's colleges in the world, and the only women's college in the city. Community Impact provides a wide variety of education, health, and social service programs in Upper Manhattan while providing meaningful volunteer and leadership opportunities for students. Outside sources often describe Barnard as part of Columbia; The New York Times in 2013, for example, called Barnard "an undergraduate women's college of Columbia University". Facebook includes Barnard students and alumnae within the Columbia interest group. Barnard students can also join extracurricular activities or organizations at Columbia University, while Columbia University students are allowed in most, but not all, Barnard organizations. Barnard's McIntosh Activities Council , named after the first President of Barnard, Millicent McIntosh, organizes various community focused events on campus, such as Big Sub and Midnight Breakfast.

McAC is made up of five sub-committees which are the Mosaic committee , the Wellness committee, the Network committee, the Community committee, and the Action committee. The college is a member of the Seven Sisters, an association of seven prominent women's liberal arts colleges in the United States of America. Mabel studied the history of women's education and began drafting feminist essays advocating for women's rights.

In 1913, one of these publications, "The Meaning of Woman Suffrage" was published in Chinese Students' Monthly by the Chinese Students' Alliance of the United States of America. Mabel was a prominent member in this organization and at one point ran for president. While at Barnard, she also joined the Philosophy Club, where she was elected Treasurer and then President. She participated in the Young Woman's Christian Association, as well, and was a member of the Silver Bay Girls . These activities reflected Mabel's devotion to her faith and community.

In the summer of the Bridgewater Scholars' junior year, students will receive guaranteed funding for 10 weeks of paid internship experience, at Bridgewater or elsewhere in the industry. Mentoring support and focused engagement opportunities are planned for every phase of the scholars' involvement in the program. Scholars will receive support for research at Barnard and for internship opportunities within the industry.

Scholars will have Barnard mentors to advise both their research and applied industry engagement projects, as well as Bridgewater mentors focused on career and industry advising. Scholars will benefit from networking and industry-focused talks and workshops provided by Bridgewater, and the guidance and support of other students in their scholar's cohort throughout their time at Barnard. The heart of Barnard's campus is Barnard Hall, aligned with the Barnard gates and the main east-west axis of the Columbia campus. It was built in the style of Columbia's academic buildings across the street and houses the college's athletic facilities, including LeFrak Gymnasium and the Barnard pool, as well as classrooms and lecture halls. Milbank Hall is the oldest building on campus; it was the original building when Barnard moved to Morningside Heights with Columbia in 1897.

In between are a number of academic buildings, including Altschul Hall, Lehman Hall , and the new Diana student center, completed in February 2010. For several decades, many Barnard graduates have followed their BA with an MPH. Because Mailman's MPH is broadly and deeply interdisciplinary, it is an especially good fit for Barnard students. Mailman is particularly well-known for its programs, ranging from the standard offerings in biostatistics and epidemiology to the fields of environmental health, medical anthropology, and medical history, among others.

StudyStudy OverviewGraduates of CEPH-accredited schools and programs of public health are equipped with the population health skills to address the world's most pressing health issues. Most courses at the university are open to students of both colleges, and their cultural resources are shared. Upon graduation, a Barnard student receives her degree from Columbia. Total enrollment is about 32,000; enrollment at Barnard is about 2,500 and at Teachers about 5,000.

Hailing from the great city of South Bend, Indiana, Wanja is a senior at Columbia studying Earth and Environmental Engineering. She's been a part of Sprout Up since her sophomore year and has been the materials coordinator, marketing manager, and chapter director. Wanja loves sharing an excitement for science and sustainability with the Sprout Up students. In her free time, she loves playing board games, crocheting, and going on walking tours. In general, we prioritize the safety, health and security of our participants while also striving to facilitate their immersion into Israeli life and society and their exploration of the country, as key elements of the Onward Israel Experience.

If for public heath or security related reasons the program cannot take place in Israel, Onward Israel will make efforts to conduct the program remotely. Please note, if this happens, it will affect the types of internships available. Participants who do not wish to participate on an entirely remote program will be permitted to withdraw and receive a full refund for their program fee, within a week of the decision for the program to be conducted remotely. If a program is cancelled completely due to heath or safety conditions in Israel, participants will be able to receive a full refund of their program fee. Including transparent png clip art, cartoon, icon, logo, silhouette, watercolors, outlines, etc. .

Including transparent png clip art, cartoon, icon, logo, silhouette, watercolors, outlines, etc. Barnard College Columbia University Logo Clipart is our hand-picked clip art picture from user's upload or the public internet. The clip art image is transparent background and PNG format which can be easily used for any free creative project. There are more high-quality clip art materials related to Barnard College Columbia University Logo Clipart, like college education ,university black and white,university of arizona . The Amgen Scholars Program is competitive, with awards based on grades, recommendations and career plans.

You may apply if you are a US citizen or permanent resident and currently a sophomore, junior, or non-graduating senior at a four-year college or university in the United States, Puerto Rico or other US territory. If you are a Columbia University or Barnard College undergraduate student and wish to be considered for the Amgen Scholars program, you should apply to the SURF program and you will automatically be considered for both programs. Columbia's Board of Trustees repeatedly rejected Barnard's suggestion, but in 1883 agreed to create a detailed syllabus of study for women.

While they could not attend Columbia classes, those who passed examinations based on the syllabus would receive a degree. The first such woman graduate received her bachelor's degree in 1887. A former student of the program, Annie Meyer, and other prominent New York women persuaded the board in 1889 to create a women's college connected to Columbia. Students' Hall was erected in 1916 and opened the following year on Barnard College's campus in New York City.

The building was renamed for Frederick A. P. Barnard, Columbia University's tenth president who repeatedly advocated for women's admission to the university. While women were barred from attending Columbia's various colleges into the first half of the 1900s, Barnard College was founded in 1889, as an affiliated college for women. The new partnership between Bridgewater and Barnard will not only benefit those who are selected into the Scholars program — it will also expand access to information and opportunities more broadly. Bridgewater-sponsored lectures and symposia will be open to all Barnard students and alumnae, in addition to faculty and staff at Barnard and Columbia University.

In a video of the incident provided by Barnard student Caroline Cutlip, McNab can be heard telling the public safety officers to "take your hands off me" multiple times. This presents a unique opportunity for Barnard students, enabling them to decrease the length of time to obtain an MPH. Columbia University is one of the world's most important centers of research and at the same time a distinctive and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. Gain international work experience in order to set yourself apart as you move forward on your career path!

The Columbia/Barnard Hillel Onward Israel 8 week program offers you a chance to expand and deepen your internship and to gain professional skills, relationships, and experience. You will spend your time on the program interning in Israel and immersing yourself in Israeli culture. As a college for women, Barnard embraces its responsibility to address issues of gender in all of their complexity and urgency and to help students achieve the personal strength that will enable them to meet the challenges they will encounter throughout their lives. Located in the cosmopolitan environment of New York City and committed to diversity in its student body, faculty, and staff, Barnard prepares its graduates to flourish in different cultural surroundings in an increasingly interconnected world. Illinois College is a small residential liberal arts college offering exceptional education at an af...

What Is The Drug Of Choice For Status Epilepticus

Adult studies of benzodiazepine efficacyLeppik et al. conducted the first study with a head-to-head comparison of benzodiazepine use in patients with SE. Patient selection included adults with convulsive, partial, absence, partial complex, and partial elementary seizure activity. A 2-ml study drug of either 5 mg of diazepam or 2 mg of lorazepam was provided in an amber syringe used to blind the provider.

A second equivalent dose of the same study drug was provided in the event and a repeat dose was indicated after 10 min for recurrent seizures. Most patients were given a loading dose of phenytoin 30 min after initial treatment regardless of recurrence. Because no clinical standard for benzodiazepine administration existed, it was considered ethically sound to provide treatment with either diazepam or lorazepam. Retrospectively, only 70 patients fit all criteria and were selected for study; 33 were treated with diazepam and 37 with lorazepam, with no statistical difference in age or type of seizure. Seizure activity ceased with a single dose of diazepam in 58% of 33 episodes compared with 78% of 37 episodes after lorazepam administration, which did not reach statistical significance.

In patients with recurrent seizures requiring a second dose, six of 13 patients in the diazepam group experienced seizure cessation versus four of eight patients in the lorazepam group, also not reaching statistical significance. Overall, treatment with diazepam was successful 76% of the time in patients who were given either one or two doses and 89% of the time in patients treated with lorazepam. There was no significant difference noted in the onset of action, measured by the time the drug was given until the time of seizure cessation.

Adverse effects were also studied between the two groups including respiratory depression/arrest, sedation, and hypotension, which were similar between the groups in approximately 12% of patients. Although the comparison of efficacy between intravenous diazepam and lorazepam did not reach statistical significance, Leppik et al. concluded that lorazepam was "at least as effective as diazepam in the initial treatment of SE" (p. 1454). A recommendation was made for further clinical experience to determine if lorazepam should replace diazepam for initial treatment.

Although it was a small sample size, this double-blind study was a welcome addition to the medical literature and sparked the conversation of alternate benzodiazepine use in patients with SE. The management of SE in the pre-hospital setting is usually carried out by paramedics while transferring the patient to the nearest medical facility. The airway should be protected, supplementary O2 given, and, if possible, IV access obtained.2 Finger-stick blood glucose should immediately be checked, vital signs obtained and a quick and targeted assessment made in the first 5 minutes. Benzodiazepines are the first-line agents to treat SE, whether it is in the pre-hospital or in-hospital setting.

Historically, there has been very little literature on out-of-hospital treatment; this was addressed in a 2001 study comparing lorazepam, diazepam, and placebo for the treatment of SE in the prehospital setting (Alldredge et al., 2001). This randomized, double-blind trial investigated not only a comparison of the two different benzodiazepines but also the efficacy and safety of treating patients with SE prior to hospital arrival. Paramedics of the San Francisco Department of Public Health and 10 area hospitals were involved in the trial.

Between 1994 and 1999, 205 adult patients presenting with tonic-clonic seizure activity in SE were enrolled in the study. Status epilepticus in this particular study was defined as "continuous or repeated seizure activity for more than five minutes without recovery of consciousness" (p. 632). Each patient enrolled in the study received 5 mg of diazepam, 2 mg of lorazepam, or placebo intravenously. Because of the fact that delaying treatment until ED arrival was routine practice at that time, administering placebo was not considered to be an ethical concern. For recurrent or continued seizures, a second dose was given after 4 min. The study kits contained identical contents and colored glass syringes to ensure blinding.

Open-label diazepam was available in the event of a life-threatening situation. Paramedics recorded the presence of seizure activity, level of consciousness, respiratory status, and cardiovascular function every 5 min. Seizure cessation prior to arrival in the ED was the primary outcome measured, which was determined by clinically evident seizures or those witnessed on the EEG in a comatose patient. Secondary outcomes included duration of SE, out-of-hospital and transfer complications, neurological outcome and discharge, and disposition of the patient from the ED. Demographics among the three treatment groups did not vary significantly.

Status epilepticus was terminated prior to arrival in the ED in 59% of patients in the lorazepam group, 43% in the diazepam group, and 21% in the placebo group. The odds ratio indicated that seizure cessation was more likely with lorazepam and diazepam than that with placebo and favored lorazepam over diazepam but did not reach significance. It was also noted that the duration of SE was shorter in the lorazepam group than in both the placebo and diazepam groups, but it only reached significance when lorazepam versus placebo was compared. Out-of-hospital complications including respiratory or cardiovascular compromise occurred in 10% of patients in both the lorazepam and diazepam groups and 23% of the placebo group.

In addition, patients with seizure cessation prior to arrival in the ED had a much lower rate of admission to the hospital (73% vs. 32%). Alldredge et al. concluded that the trial provided clear evidence that intravenous benzodiazepine use is safe and effective in the prehospital setting and lorazepam was favored over diazepam. This trial was important because it encouraged the use of antiepileptics for the prehospital treatment of SE-a change from the previously common practice of delaying treatment until arrival in the ED. It is extremely important to recognize and control SE since prolonged SE can quickly develop into refractory SE, which is very difficult to treat .

In addition, prompt SE treatment is essential to prevent mortality and the progressive brain damage that produces neurological morbidities. Treatment of SE begins with medical stabilization of the patient with an initial focus on respiratory and circulatory stabilization. Further evaluations are then made looking for underlying causes of SE (metabolic disturbances, infections, etc.) and treatments are provided to correct them. Following these emergency stabilizations of the patient's physiological status, treatment of SE is rapidly initiated using currently accepted first line drugs for stopping SE.

This usually includes immediate treatment with benzodiazepines such as midazolam, diazepam, or lorazepam. The second-line of drugs to control SE include fosphenytoin, phenytoin, phenobarbital, and valproic acid. Clinical trials have shown that patients treated within 20 min of SE had better prognoses than those who did not respond within 20 min . However, epidemiological studies have shown that time to seizure treatment varies broadly with only about 41% of all patients receiving their first anti-epileptic drug within 30 min . In such a scenario, the treatment options become extremely limited to drugs such as pentobarbital, midazolam, or propofol. Topiramate and ketamine are used as additive agents to benzodiazepines and first line drugs to control refractory SE .

However drug interactions, side-effects, pharmacoresistance, CNS depression, all add to the medical complexity of treating SE effectively and highlight the need to develop additional agents to treat SE. In convulsive status epilepticus , achieving seizure control within the first 1–2 hours after onset is a significant determinant of outcome. Treatment is also more likely to work and be cost effective the earlier it is given. Initial first aid measures should be accompanied by establishing intravenous access if possible and administering thiamine and glucose if required. Calling for help will support efficient management, and also the potential for video-recording the events. This can be done as a best interests investigation to inform later management, provided adequate steps to protect data are taken.

There is high quality evidence supporting the use of benzodiazepines for initial treatment. Midazolam has the most evidence where there is no intravenous access, with the practical advantages of administration outweighing the slightly slower onset of action. Speed of administration and adequate initial dosing are probably more important than choice of drug. Although only phenytoin and phenobarbitone are licensed for established SE, a now considerable body of evidence and international consensus supports the utility of both levetiracetam and valproate as options in established status.

Both also have the advantage of being well tolerated as maintenance treatment, and possibly a lower risk of serious adverse events. Two adequately powered randomized open studies in children have recently reported, supporting the use of levetiracetam as an alterantive to phenytoin. The results of a large double blind study also including valproate are also imminent, and together likely to change practice in benzodiazepine-resistant SE. Status epilepticus should be treated as quickly as possible with full doses of medications as detailed in a written hospital protocol. If intravenous access is not immediately available, then rectal diazepam or nasal or buccal midazolam should be given. Prehospital treatment of seizures by emergency personnel is effective and safe, and may prevent cases of refractory SE.

Home treatment of prolonged seizures or clusters with buccal, nasal, or rectal benzodiazepines should be considered for all at-risk patients. An electroencephalogram should be obtained immediately in anyone with unexplained alteration of behavior or mental status and after convulsive SE if the patient does not rapidly awaken. Delay in diagnosis of SE is associated with a worse outcome and a higher likelihood of poor response to treatment. For refractory SE, continuous intravenous midazolam and propofol are rapidly effective. Randomized trials are needed to determine the best treatment for SE after lorazepam. SE can occur in dogs with idiopathic epilepsy , structural epilepsy or reactive seizures .

In general, 0.5–2.6% of dogs are admitted to the emergency hospital for SE . Among the population of dogs presenting to hospital for seizures, 16.5% manifest SE and the latter has been identified as the first clinical manifestation of an epileptic seizure disorder in 58% of dogs . Studies showed that 32–40%, 27–59%, and 7–23% of dogs with structural epilepsy, IE, and reactive seizures, respectively, can present with SE . SE can lead to permanent brain damage (e.g. neuronal cell necrosis, network reorganization, gliosis) and severe systemic complications (e.g. cardiorespiratory collapse, shock, acidosis, electrolyte imbalances) .

The occurrence and severity of SE-induced complications are proportionally related to the duration of seizure activity . With regard to the survival rates, an overall mortality rate of 25.3–38.5% among all dogs presented with SE has been reported . Therefore, clinicians or owners should quickly intervene to cease the continuous seizure activity either in hospital or at home, respectively . Owners, in particular, have a substantial role in seizure control because appropriate administration of antiseizure drugs at home could prevent seizure progression to SE or reduce the risk of progression to more refractory stages. First-line management is of paramount importance and should include drugs with high potency and rapid onset of action. Benzodiazepines have been exclusively used for decades in humans and animals as first-line antiseizure treatment due to their high potency and rapid onset of action .

Benzodiazepines are recommended universally as the first-line therapy to address acute SE, and the choice of agent and route should account for drug properties, technical requirements, and comparative efficacy. When intravenous access is available, the literature suggests that lorazepam shows the best efficacy for seizure cessation while providing consistent CNS concentrations along with a favorable safety profile. Continued research should focus on drugs or combinations of drugs that achieve consistent cessation of seizure activity. In addition, limited data exist to describe the effect of drug selection on long-term outcomes in these patients.

Because of evidence of low rates of respiratory and cardiovascular compromise with benzodiazepine use in SE, it may be worthwhile to conduct research on higher doses of benzodiazepine use in an effort to increase efficacy. Occurring in about 8% of all comatose patients without clinical signs of seizure activity , and persisting in 14% of patients after generalized convulsive status epilepticus , and constitutes approximately 20 to 25% of status epilepticus cases . Patients who have generalized seizures that continue for more than 5 min should be considered to have status epilepticus and should be treated with a single IV dose of lorazepam (0.1 mg/kg). Patients who continue to have clinical or EEG evidence of seizure activity after receiving treatment with lorazepam should be considered to have refractory status epilepticus and should treated with a continuous infusion of propofol or midazolam . Status epilepticus is a life-threatening neurological medical emergency caused by the prolongation of a seizure that fails to terminate due to an imbalance between excitatory and inhibitory neurotransmitters/mechanisms in the brain. It is defined as a seizure lasting 5 minutes or more, or a recurrent seizure without a recovery phase.

In 1983 Gastaut identified status epilepticus as, "when an epileptic seizure is so frequently repeated or so prolonged as to create a fixed and lasting condition". There is no established system for the classification of status epilepticus. Status epilepticus may be caused by epilepsy, stroke, infection, metabolic imbalance, cerebral trauma or cerebrovascular accidents, hypoxia, eclampsia, and drug toxicity. Status epilepticus must be differentiated from other disorders that may mimic the clinic presentation such as neuroleptic malignant syndrome, psychogenic nonepileptic seizures, delerium tremens, low blood sugar, and movement disorders. The incidence of status epilepticus is approximately 7 to 40 cases per 100,000/year.

Common risk factors in the development of status epilepticus include inadequate control of epilepsy, hypoglycemia, stroke, alcohol use, metabolic abnormalities, anoxia, hypoxia, tumors, and infections. Common complications of status epilepticus include cardiac dysrhythmia, metabolic derangements, autonomic dysfunction, neurogenic pulmonary edema, hyperthermia, rhabdomyolysis, and aspiration pneumonia. Brain injury can be minimized by; airway patency, adequate oxygenation/circulation, prevention of hypoglycemia, maintaining optimum body temperature, termination of a seizure by antiepileptic drugs. Lorazepam is a preferred benzodiazepine due to its low lipid solubility, rapid onset, long duration of action and high affinity to GABA receptor. Diazepam can be administered if lorazepam is not available or there is no IV access. The choice and route of administration of benzodiazepines for the treatment of acute status epilepticus in both prehospital and emergency department settings often vary by provider and institution.

Prehospital and ED care often involves intramuscular, intravenous, or rectal administration of these medications. Diazepam, lorazepam, and midazolam are available as parenteral formulations in the United States. A literature review of clinical trials and SE treatment guidelines was conducted in an attempt to identify which benzodiazepine and route are the best treatment option for adult patients with SE.

For initial treatment of SE in adults, intravenous lorazepam is the recommended drug of choice. However, evidence suggests that intramuscular midazolam has at least equal efficacy in prehospital settings and may be more appropriate for use in this environment. Despite the support of multiple clinical trials and treatment guidelines, inconsistencies in the treatment of acute SE continue to occur in both the prehospital and ED settings.

Status epilepticus is a common neurological emergency, with high morbidity and mortality, now defined as 5 minutes or more of continuous clinical and/or electrographic seizure activity or recurrent seizure activity without recovery between seizures. In observational studies, many disparities exist in management among different medical teams. Here, the author reviews evidence-based medicine data on this management, with emphasis on the use of drugs and electroencephalography. When a patient is still seizing thereafter, the second line is usually either IV phenytoin or IV valproate, where available. Status epilepticus or prolonged epileptic seizure activity is a common neurological emergency with a high mortality rate and, if left untreated, can lead to irreversible cerebral damage and systemic complications.

Fast and effective first-line management is of paramount importance, particularly in the at-home management of seizures where drug administration routes are limited. Benzodiazepines have been for decades exclusively used in veterinary medicine as first-line drugs based on their high potency and rapid onset of action. Various administration routes exist in dogs, such as oral, intravenous, intramuscular, rectal, and intranasal, all with different advantages and limitations. Recently, intranasal drug delivery has become more popular due to its unique and favourable characteristics, providing potential advantages over other routes of drug administration in the management of canine SE.

Benzodiazepines have been exclusively used in veterinary medicine for decades as first-line drugs based on their high potency and rapid onset of action. Clonazepam is more lipophilic than lorazepam, but less lipophilic than diazepam, making it therefore less prone to redistribution. Its long half-life of 17–55 hs and rapid onset of action makes it an attractive agent for emergency treatment of seizures and SE.

To date, there is limited evidence to support the use of IV clonazepam in the treatment of early SE. In one uncontrolled case series with SE treated with this drug, seizure cessation was reported in all patients after administration of doses between 0.25 and 0.75 mg, with no adverse effects reported . Adverse effects consisted exclusively of transient mild to moderate drowsiness occurring in 40 % of the patients. One study comparing IV clonazepam alone to clonazepam followed by levetiracetam in generalized CSE was reported to recruit in 2011, but final results have not been published yet . Convulsive status epilepticus is an emergency that is associated with high morbidity and mortality.

The outcome largely depends on etiology, but prompt and appropriate pharmacological therapy can reduce morbidity and mortality. Etiology varies in children and adults and reflects the distribution of disease in these age groups. Antiepileptic drug administration should be initiated whenever a seizure has lasted 10 minutes.

Immediate concerns include supporting respiration, maintaining blood pressure, gaining intravenous access, and identifying and treating the underlying cause. Initial therapeutic and diagnostic measures are conducted simultaneously. The goal of therapy is rapid termination of clinical and electrical seizure activity; the longer a seizure continues, the greater the likelihood of an adverse outcome. Common to all patients is the need for a clear plan, prompt administration of appropriate drugs in adequate doses, and attention to the possibility of apnea, hypoventilation, or other metabolic abnormalities. We have not identified any new high-quality evidence on the efficacy or safety of an anticonvulsant in stopping an acute tonic-clonic convulsion that would inform clinical practice. There appears to be a very low risk of adverse events, specifically respiratory depression.