- Reported/witnessed seizure activity
- Previous seizure history
- Medical alert tag information
- Seizure medications
- History of trauma
- History of diabetes
- History of pregnancy
- Decreased mental status
- Observed seizure activity
- Evidence of trauma
- CNS (head) trauma/stroke
- Metabolic, hepatic, or renal failure
- Electrolyte abnormality (Na, Ca, Mg)
- Alcohol withdrawal
- Consider 12-Lead EKG
- Obtain BGL
Still Seizing ?
- Follow Appropriate Guideline
- Status epilepticus is defined as two or more successive seizures without a period of consciousness or recovery. 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 are not usually associated with a loss of consciousness.
- Jacksonian seizures are seizures which start as a focal seizure and become generalized.
- Be prepared for airway problems and continued seizures.
- Assess possibility of occult trauma and substance abuse.
- Be prepared to assist ventilations especially if Midazolam (Versed) or Diazepam (Valium) is used.
- For any seizure in a pregnant patient, follow the Eclampsia/Pre-eclampsia Protocol.
- Consider Lorazepam (Ativan) IV push if hypotensive
- The maximum dose without Medical Control for Lorazepam (Ativan) is 4 mg and Midazolam (Versed) is 12.5 mg. DO NOT exceed maximum