Central Nervous System

Seizures and Status Epilepticus

Continuous generalized seizures or repeated seizures without return to consciousness.

1) Administer O2 at 15 liters/minute by mask or BVM ventilation

2) Do blood glucose test

3) If seizure has lasted more than 5 minutes since it began, administer one dose of Midazolam 2 mg IN or IM

a) 5 mg/ml concentration must be used for IN route

4) Observe response and re-evaluate for repeat dose at 2 minutes.

5) If Midazolam is not available, establish an IV NS at TKO then administer Diazepam 1 mg slow IV push, followed with a NS flush; reassess for seizure after 2 minutes and, if needed, may repeat dosing up to a maximum of 10 mg IV or use rectal dosing

6) If using rectal dosing, administer one dose of Diazepam rectally, dosed by both age and estimated weight:

a) For < 6 y/o give 0.5 mg/kg

b) For 6-11 y/o give 0.3 mg/kg

c) For > 11 y/o give 0.2 mg/kg Up to 10 mg maximum

7) If Diazepam is unavailable, substitute with Lorazepam 0.1 mg/kg slow IV push or IN mist, up to maximum 4 mg per dose