Course info

Summary: Seizures are one of the most common reasons why bystanders call Emergency Medical Services (EMS) for a child, and current practice frequently fails due to under-dosing and delayed delivery of anti-seizure medication. Benzodiazepines, such as midazolam, given in the nose or as a muscular injection are the first line treatment for seizures. Unfortunately, one-third of actively seizing children have ongoing seizures on arrival at the emergency department (ED) because an inadequate and delayed dose of midazolam fails to stop seizures. Children who continue to seize have seizures that are harder to stop, and this puts them at risk for not breathing and having brain damage. Reducing this risk requires equipping paramedics with a simplified method for rapidly determining and administering a therapeutic dose of medication. Paramedics suggest simplifying midazolam dosing by eliminating the error-prone, sequential calculations required to determine a weight-based dose under stressful conditions. Standardized, age-based dosing may be simpler, faster and more effective, without compromising safety. The study's purpose is to compare the impact of standardized EMS midazolam dosing relative to conventional dosing on seizure cessation. The study also aims to determine how often children stop breathing or ineffectively breathe after implementation of standardized EMS midazolam dosing. 

Study Population: Patients ≥ 6months to ≤ 13 years and witnessed by paramedic to be actively seizing, regardless of seizure type or duration and under the care of a paramedic.