- Administer high flow oxygen. (See Oxygen Administration)
- 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.
- Initiate transport.
- 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)
Continuous seizure activity for longer than 3 minutes or
two or more consecutive seizures without regaining consciousness.
- Assist ventilations. (See Airway Management Protocol)
- Contact receiving facility for further orders if ALS is not on scene. Request advanced life support.
- Perform Blood Glucose analysis if available. If hypoglycemic, follow hypoglycemia BLS protocol in “Altered Level of Consciousness”.
- Perform blood glucose analysis. If blood glucose < 70 mg/dL, refer to hypoglycemia protocol in “Altered Level of Consciousness”.
- Apply the cardiac monitor and pulse oximeter.
- Administer midazolam IV, IM, or intra-nasal:
- If patient ≥ 50 kg, administer 5 mg
- If patient < 50 kg, administer 2.5 mg
- 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