SEIZURE (ADULT)
ALL LEVELS
DESIGNATION OF CONDITION
Most seizures spontaneously end within 5 minutes with a postictal state of varying length, with unconsciousness or altered LOC. Seizures occurring during response should be treated expeditiously.
Status epilepticus exists when witnessed seizure activity continues for > 5 minutes or multiple seizures recur without a return to full mental capacity. Signs and symptoms may include any one or all of the following: may experience an aura, violent spasms of muscles lasting up to 3 - 5 minutes, incontinence, increased salivation, postictal phase, possible history of drug usage for seizures.
EMPHASIS ON PATIENT CARE
1. Maintain adequate airway, adequate oxygenation, protect patient from harm
2. Primary Management - Assess ABC’s and manage as indicated.
3. Secondary Management - History, physical exam, vital signs
4. Initiate transport to an appropriate medical facility, request ALS intercept.
a. Determine blood glucose level
b. Cardiac monitoring
c. Monitor the patient’s vital signs
AEMT
1. In route, initiate a large bore IV/IO of an isotonic solution at a TKO rate.
PARAMEDIC
1. For ADULT seizures administer:
a. MIDAZOLAM 10 mg. IM administration has proven to be the safest and easiest route and is nearly as rapid in onset as IV/IO/IN administration. May be repeated as needed.
b. MIDAZOLAM [2-4mg] slow IV/IO/IN. Repeat dose if needed to max of 10mg.
ALL LEVELS
DESIGNATION OF CONDITION
Most seizures spontaneously end within 5 minutes with a postictal state of varying length, with unconsciousness or altered LOC. Seizures occurring during response should be treated expeditiously.
Status epilepticus exists when witnessed seizure activity continues for > 5 minutes or multiple seizures recur without a return to full mental capacity. Signs and symptoms may include any one or all of the following: may experience an aura, violent spasms of muscles lasting up to 3 - 5 minutes, incontinence, increased salivation, postictal phase, possible history of drug usage for seizures.
EMPHASIS ON PATIENT CARE
1. Maintain adequate airway, adequate oxygenation, protect patient from harm
2. Primary Management - Assess ABC’s and manage as indicated.
3. Secondary Management - History, physical exam, vital signs
4. Initiate transport to an appropriate medical facility, request ALS intercept.
a. Determine blood glucose level
b. Cardiac monitoring
c. Monitor the patient’s vital signs
AEMT
1. In route, initiate a large bore IV/IO of an isotonic solution at a TKO rate.
PARAMEDIC
1. For ADULT seizures administer:
a. MIDAZOLAM 10 mg. IM administration has proven to be the safest and easiest route and is nearly as rapid in onset as IV/IO/IN administration. May be repeated as needed.
b. MIDAZOLAM [2-4mg] slow IV/IO/IN. Repeat dose if needed to max of 10mg.