- Reported/witnessed seizure activity
- Previous seizure history
- Seizure medications
- History of recent head trauma
- Congenital abnormality
- Consider pregnancy in teenage females
- Decreased mental status
- Observed seizure activity
- Hot, dry skin/hyperthermia
- CNS (head) trauma
- Hypoxia/respiratory failure
- Metabolic abnormality/acidosis
- Midazolam (Versed) 0.1 mg/kg IM, Max 5 mg (if no IV/IO established)
Still seizing ?
- Pediatric = 1 day to less than age 12, or less than 55 kg in ages 12-18.
- Use Handtevy for drug dosages.
- Addressing the ABC's and verifying blood glucose is more important than stopping the seizure.
- Avoiding hypoxemia is extremely important.
- Abnormal eye movements are most common sign of seizures in neonates.
- Remember to look for evidence of trauma and treat accordingly.
- Status epilepticus is defined as two or more successive seizures without a period of consciousness or recovery. This includes failure to return to consciouness greater than 5 minutes. This is a true emergency requiring rapid airway control, treatment, and transport.
- Grand mal seizures (generalized) are associated with loss of consciousness, incontinence, and tongue trauma.
- Focal seizures (petit mal) effect only a part of the body and do not usually result in a loss of consciousness.
- Jacksonian seizures are seizures, which start as a focal seizure and become generalized.
- Be prepared to assist ventilations especially if Midazolam (Versed) is used.
- If evidence or suspicion of trauma, spine should be immobilized.
- In an infant, a seizure may be the only evidence of a closed head injury.
- If family has Diastat on scene, Paramedics may give per medication instructions.