Seizure - Pediatric




  • Reported/witnessed seizure activity
  • Previous seizure history
  • Seizure medications
  • History of recent head trauma
  • Fever
  • Congenital abnormality
  • Consider pregnancy in teenage females


Significant Findings:


  • Decreased mental status
  • Sleepiness
  • Observed seizure activity
  • Hot, dry skin/hyperthermia




  • CNS (head) trauma
  • Tumor
  • Hypoxia/respiratory failure
  • Drugs/medications
  • Fever
  • Infection
  • Metabolic abnormality/acidosis




    • Oxygen
    • Consider 12-Lead EKG
    • Obtain BGL
    • Initiate IV


    • Midazolam (Versed) 0.1 mg/kg IM, Max 5 mg (if no IV/IO established)



Still seizing ?


  • Yes
  • OLMC






  • 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.