Seizures

1. Follow General Medical Protocol.

2. Mandatory interventions:

a. Cardiac monitoring

b. Oxygen

c. IV access

d. Rapid glucose testing

3. 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.

4. If HYPOGLYCEMIA present, refer to Diabetic Emergencies – Hypoglycemia Protocol.

5. For ACTIVE SEIZURE, administer:

a. If > 50 kg: MIDAZOLAM (Versed) 10 mg IM in anterior thigh 

OR 2 - 5 mg IV max of 10mg

• Continuous seizures a 5mg IV dose may be given max of 10mg

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.

6. Suction as needed.

7. If not contraindicated, turn patient to a lateral recumbent position.

8. Continue to observe and transport.

9. If the patient is PREGNANT, administer MAGNESIUM SULFATE 50% 4 grams added to 1-liter 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.