Maine:Prehospital protocol pediatric seizure

Baseline Assessment

• 100% O2 NRB and prepare to assist ventilations
• Obtain vital signs and prtoect patient from self injury
• Request ALS

Actively seizing?

• Check blood glucose

Blood Glucose <60 mg/dL?

Yes

• Treat with Dextrose IV/IO

Active Seizure?

Yes

• Midazolam (weight *0.2 mg/kg) IM (max 10mg)
• Midazolam (weight *0.1mg/kg) IV (Max 5mg)
• Midazolam (weight 0.2mg/kg) IN over 15 sec half in each nostril (max 6mg)

No

• Further orders per on-line physician

Continuing seizure > 5 min?

• Obtain IV access
• Begin EtCO2 monitoring

Yes

• Give IV/IO midazolam (weight * 0.1) mg OR
• Give IM/IN midazolam (weight * 0.2) mg

Reassess Patient

• Continue to monitor airway
• Further orders as per on-line physician