How can we minimise the risks to patients when using intravenous phenytoin in status epilepticus (SE)?

Intravenous phenytoin is one of a number of treatments that can be used to manage status epilepticus (SE); this is a condition where a convulsive seizure continues for a prolonged period (longer than 5 minutes), or when convulsive seizures occur one after the other with no recovery between. Convulsive status epilepticus is an emergency and requires immediate medical attention.

The use of intravenous phenytoin in this situation requires care as there are a number of factors that can lead to patient risk and harm. These factors and how to manage them are discussed below.  This Q and A focusses on adults.