Seizures - Adult
  1. Administer high flow oxygen. (See Oxygen Administration)

  3. Protect patient from injury while patient is seizing. DO NOT RESTRAIN PATIENT. DO NOT FORCE A BITE STICK INTO THE PATIENT'S MOUTH. Determine the duration of the seizure. Observe the type of seizure activity and what part(s) of the body it affects.


Not in Status Seizures


  1. Initiate transport.

    1. Adult patients who are no longer post-ictal may request not to be transported. You should consult with the hospital for authorization not to transport. (See Non-Transported Patient Protocol)


Status Seizures


Criteria: Continuous seizure activity for longer than 3 minutes or two or more consecutive seizures without regaining consciousness.




  1. Assist ventilations. (See Airway Management Protocol)

  3. Contact receiving facility for further orders if ALS is not on scene. Request advanced life support.

  5. Perform Blood Glucose analysis if available. If hypoglycemic, follow hypoglycemia BLS protocol in “Altered Level of Consciousness”.




    1. Perform blood glucose analysis. If blood glucose < 70 mg/dL, refer to hypoglycemia protocol in “Altered Level of Consciousness”.

    3. Apply the cardiac monitor and pulse oximeter.

    5. Administer midazolam IV, IM, or intra-nasal:

      1. If patient ≥ 50 kg, administer 5 mg
      2. If patient < 50 kg, administer 2.5 mg
      3. Dose may be repeated in 5 minutes, if needed; use other nare if administered intranasally. Contact the receiving facility for additional doses of midazolam.
Note: Patient must be placed on nasal waveform capnography.


If the patient is pregnant in the 3rd trimester, administer 2 grams magnesium IVP over 2 minutes