Protocol 2-792 - Seizure

CMH EMS & MIH Protocols

EMD:

• No specific protocol.

EMR:

• Ensure open Airway.
• Identify possible causes. Options include:
• Alcohol use or withdrawl
• Brain injury or tumor
• Drug use or withdrawl
• Epilepsy
• Fever
• Hypertension
• Hyperthermia
• Hypoglycemia
• Poisoning
• Stroke
• Clear area to decrease chance of injury.
• Consider Oxygen if SpO2 less than 88%.
• Apply Cardiac Monitor limb leads.

EMT:

• Ensure completion of applicable items above.
• Perform Blood Sugar Check.
• Consider assisting ALS with Capnography.
• No history of siezures, afebrile, and destination hospital is on CT divert: Bypass that facility and transport to next closest appropriate facility taking into consideration the patient's wishes.

AEMT:

• Ensure completion of applicable items above.
• Consider IV NS/LR.

RN:

• Ensure completion of all applicable items above.
• Consider IO NS/LR.
• Actively seizing: Continue Versed as below until seizures stopped. Max single dose of 5 mg IV/IO/IN or 10 mg IM.

• Adult:	Pediatric:
  Consider Versed 10 mg IM. OR Versed 2.5-5 mg IV/IO/IN Pregnant Hypertension (20-week gestation through 4-week post-partum): Magnesium Sulfate 4 g IM/IV/IO (IV/IO in NS over 5 minutes) and refer to Protocol 2-528 - Hypertension.	12-18 year old: Consider Versed same as adult. 1-12 year old: Consider Versed 0.15 mg/kg (max 5 mg) IM/IV/IO. May repeat every 5 minutes. Click "calculate" to get dose. 1-12 month old: Consider Versed 0.2 mg/kg IM/IN (max 5 mg). May repeat every 5 minutes. Click "calculate" to get dose.

Medic:

• Ensure completion of all applicable items above.
• Use RSI with caution in seizure patients. Paralysis only masks the manifestation of seizure.
• Continued sedation for intubated patient: Versed 2.5-5 mg IV/IO.

CP:

• Ensure completion of all applicable items above.

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