string(11) "/protocols/"

18.1 SEIZURES

All Providers

  • Focused history and physical exam
    • Blood glucose, assess temperature, oxygen saturation
    • Determine possibility of third trimester pregnancy, if appropriate
    • Assess scene for possible toxin, trauma, or overdose
  • Cardiac monitor, ETCO2 if available
  • Treatment Plan
    • Do not restrain but protect from injury
    • Selective Spinal Immobilization Protocol
    • Unbundle patients if febrile seizure is possible
    • Transport all seizure patients to closest hospital unless OLMC gives clearance
    • Maintain open airway with patient in the recovery position
Key Considerations
  • Intranasal (IN or intramuscular (IM) routes are preferred for first line administration of benzodiazepines until IV access is established

Adult

EMT
  • Consider advanced airway
AEMT
  • IV/IO Access and Fluid protocol if necessary
  • Midazolam
    • maximum of 10 mg
    • IV/IO: 5 mg, may repeat in 5 minutes
    • IM/IN: 10 mg
Paramedic
  • Pregnant females with eclampsia/seizures
  • Contact OLMC for refractory seizure

Pediatric
not to exceed adult dose

EMT
  • Consider advanced airway
AEMT
  • IV/IO Access and Fluid protocol if necessary
  • Midazolam
    • IN/IM: 0.2 mg/kg (max of 10 mg), may repeat one time after 5 minutes
    • IV/IO: 0.1 mg/kg (max 5 mg), may repeat one time
Paramedic
  • Contact OLMC for refractory seizure