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Section 5 -MEDICAL


INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% via NRB mask:

  • Institute if patient had a grand mal seizure PTA or is actively having grand mal seizure.
  • Protect airway and protect patient from injury. Vomiting / aspiration precautions. Place nothing in mouth during seizure. Observe type, location and duration of seizure activity.
  • Obtain and record blood sugar level and refer to HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS, (5.10) as indicated.
  • If current seizure activity lasting greater than 10 minutes,
    • VALIUM 2 - 20 mg Slow IVP for adults, titrated to control seizure activity. If no IV access, administer VALIUM 10 - 20 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.
    • OR MIDAZOLAM (VERSED) 5 mg IV, IM, IO or IN.
  • Refer to Handtevy System for pediatric administration. If no IV access in PEDIATRICS, rectal administration may be used, per Handtevy System.
  • Observe patient's sensorium and airway during post-ictal period. Note any injury sustained during seizure and / or any incontinence.
  • If febrile seizure, refer to PEDIATRIC FEBRILE EMERGENCY PRACTICE PARAMETER (7.10).


  • If a patient has been treated for seizures, transport is not required if:
    • The patient is stable.
    • The patient has a competent adult that will remain with the patient for hours.
    • The patient understands and agrees to the following instructions to take medication if indicated and call back if necessary.
  • For seizures, the patient cannot have:
    • fever
    • repetitive seizures
    • an unusual seizure for the patient
    • New onset of seizures
  • Any Questions, refer to REFUSAL OF SERVICE PRACTICE PARAMETER (1.03)