Seizure

Section 5 -MEDICAL

5.12 SEIZURE

INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% via NRB mask:

• Institute if patient had a grand mal seizure PTA or is actively having grand mal seizure.
• Protect airway and protect patient from injury. Vomiting / aspiration precautions. Place nothing in mouth during seizure. Observe type, location and duration of seizure activity.
• Obtain and record blood sugar level and refer to HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS, (5.10) as indicated.
• If current seizure activity lasting greater than 10 minutes,
  • DIAZEPAM 2 - 20 mg Slow IVP for adults, titrated to control seizure activity. If no IV access, administer DIAZEPAM 10 - 20 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.
  • OR LORAZAPAM 1 - 2 mg Slow IVP for adults, titrated to control seizure activity. If no IV access, administer LORAZAPAM 1 - 2 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site
  • OR MIDAZOLAM (VERSED) 5 mg IV, IM, IO or IN.

• Refer to Handtevy System for pediatric administration. If no IV access in PEDIATRICS, rectal administration may be used, per Handtevy System.
• Observe patient's sensorium and airway during post-ictal period. Note any injury sustained during seizure and / or any incontinence.
• If febrile seizure, refer to PEDIATRIC FEBRILE EMERGENCY PRACTICE PARAMETER (7.10).

PATIENT REFUSALS

• If a patient has been treated for seizures, transport is not required if:
  • The patient is stable.
  • The patient has a competent adult that will remain with the patient for hours.
  • The patient understands and agrees to the following instructions to take medication if indicated and call back if necessary.
• For seizures, the patient cannot have:
  • fever
  • repetitive seizures
  • an unusual seizure for the patient
  • New onset of seizures
• Any Questions, refer to REFUSAL OF SERVICE PRACTICE PARAMETER (1.03)