Guidelines for Treatment of Prolonged Seizures in Children and Adults

An actively seizing patient is a relatively common prehospital emergency, and all EMS providers need to be expert at caring for patients with seizures. Although most seizures stop spontaneously, it's essential to have a well-planned strategy when a patient with active seizures is encountered. The American Epilepsy Society has recently released its evidence-based guidelines for the treatment of actively seizing children and adults, and this article incorporates its treatment recommendations. Many terms are used to describe seizure duration. In general, "brief seizures" are self-limited seizures which last less than five minutes and prolonged seizures are those that don't self-terminate and continue for longer than five minutes.1 Status epilepticus is defined in the neurologic literature as continued seizure activity lasting longer than 30 minutes, or two or more seizures without the patient regaining normal consciousness over a 30-minute period.1 Because prolonged seizures lasting more than five minutes are referred to as status seizures by most non-neurologist providers including EMS personnel, and are also likely not to self-terminate without medical intervention, recent guidelines do not differentiate between status epilepticus and seizures lasting more than five minutes. Practically speaking, providers can assume a patient is in status epilepticus when a patient is still seizing from the time 9-1-1 is called until EMS arrives on scene, as this time duration is ty...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Source Type: news