DESIGNATION OF CONDITION

Most seizures spontaneously end within 5 minutes with a postictal state of varying length, with unconsciousness or altered LOC. These seizures do not require advanced level intervention. Status epilepticus exists when witnessed seizure activity continues for > 10 minutes or multiple seizures recur without a return to full mental capacity. These types of seizures do require paramedic level intervention. Signs and symptoms may include any one or all of the following: may experience an aura, violent spasms of muscles lasting up to 3 - 5 minutes, incontinence, increased salivation, postictal phase, possible history of drug usage for seizures.

EMPHASIS ON PATIENT CARE

Maintain adequate airway, adequate oxygenation, protect patient from harm.

FIRST RESPONDER AND BASIC PRE-HOSPITAL MANAGEMENT

• Initial Management - Assess airway, breathing and circulation and manage as indicated
• Focused H&P - History, physical exam, vital signs.
• Initiate transport (BASIC and above) to an appropriate medical facility, consider ILS/ALS intercept.
  • Determine blood glucose level.
  • Cardiac monitoring.
  • Monitor the patient’s vital signs.

INTERMEDIATE PRE-HOSPITAL MANAGEMENT

• En-route, initiate a large bore IV of an isotonic solution at a TKO rate.

PARAMEDIC PRE-HOSPITAL MANAGEMENT

• For status epilepticus:
• Adult - administer DIAZEPAM [2-10 mg], slow IVP or LORAZEPAM [2-4mg].
• Pediatric - administer DIAZEPAM [0.2-0.3 mg/kg], slow IVP.