Follow General Medical Protocol.
Mandatory interventions:
a. Cardiac monitoring
b. Oxygen
c. IV access
d. Rapid glucose testing
Assure that patient has a patent airway. DO NOT stick any object into mouth during active seizure. Intubate patient after the seizure if the patient is in respiratory failure/distress.
If HYPOGLYCEMIA present, refer to Diabetic Emergencies – Hypoglycemia Protocol.
For ACTIVE SEIZURE, administer:
a. If > 50 kg: MIDAZOLAM (Versed) 10 mg IM in anterior thigh OR 2 - 5 mg IV. May repeat 5mg IV X1 for recurrent seizure.
b. If < 50 kg: MIDAZOLAM (Versed) 0.2 mg/kg IM/IV.
c. DO NOT administer midazolam to an already postictal patient. Contact Medical Control if seizures continue (“status epilepticus”) despite maximum EMS dose of midazolam – especially if prolonged transport OR intubation contemplated.
Suction as needed.
If not contraindicated, turn patient to a lateral recumbent position.
Continue to observe and transport.
If the patient is PREGNANT, administer MAGNESIUM SULFATE 50% 4 grams added to 1-liter Isotonic Solution (NS or LR) 0.9% NORMAL SALINE IV wide-open until seizures stop OR until 4 grams have been administered. THIS IS DRUG-OF-CHOICE FOR SEIZURES IN PREGNANCY.