Patient Encounter Part 3 Treatment Failure

It has been 45 minutes since CH's arrival, and he has been given lorazepam 4 mg twice and loaded with 1,500 mg of phenytoin. He received another 400 mg dose of phenytoin 15 minutes ago, but is still unarousable. His jerking movements have slowed down, but his temperature is now 39.9°C (103.8°F), and his blood pressure has dropped to 124/62 mm Hg. His oxygen saturation is 91% on 4 L oxygen via nasal cannula. Bilateral crackles are heard upon auscultation of his lungs. A CT scan of his head is obtained and shows no evidence of hemorrhage, tumor, or mass effect.

What is your assessment of this patient's condition?

What possible treatment options exist at this time?

How would you optimize this patient's outcome?

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