About
Section 1: General Patient Care
Section 2: Medical Protocols
2.01 - Adrenal Insufficiency / Crisis (Adult & Pediatric)2.02A - Allergic Reaction / Anaphylaxis2.02P - Allergic Reaction / Anaphylaxis2.03A - Altered Mental / Neurological Status / Diabetic Emergencies / Coma - Adult2.03P - Altered Mental / Neurological Status / Diabetic Emergencies / Coma - Pediatric2.04 - Behaviorial Emergencies (Adult & Pediatric)2.05 - Behaviorial Emergencies - Restraints (Adult & Pediatric)2.06A - Bronchospasm / Respiratory Distress (Adult)2.06P - Bronchospasm / Respiratory Distress (Pediatric)2.07 - Hyperthermia (Environmental - Adult & Pediatric)2.08 - Hypothermia (Environmental - Adult & Pediatric)2.09 - Nerve Agent / Organophosphate Poisoning2.10 - Obstetrical Emergencies2.11 - Newly Born Care2.12 - Resuscitation of the Newly born2.13 - Pain and Nausea Management2.14 - Poisoning / Substance Abuse / Overdose2.15A - Seizures2.15P - Seizures2.16A - Shock2.16P - Shock2.17A - Sepsis2.17P - Sepsis2.18 - Stroke2.19 - Hyperkalemia2.20 - Home Hemodialysis Emergency Disconnect
Section 3: Cardiac Emergencies
Section 4: Trauma Protocols
Section 5: Airway Protocols & Procedures
Section 6: Medical Director Options
Section 7: Medical Policies & Procedures
Section 8: Special Operations Principles
Appendices
2.15A - Seizures
EMT-Basic (Standing Orders)
- 1.0 Routine Patient Care
- Manage hypoglycemia and narcotic overdose per protocol.
- Consider eclampsia in a woman of childbearing age
CAUTION: Do NOT administer anything orally if the patient does not have a reasonable level of consciousness and normal gag reflex.
EMT-Advanced (Standing Orders)
- If Diazepam rectal gel (Diastat) has been prescribed by the patient’s physician, assist the caregiver with administration in accordance with physician’s instructions.
- If the patient has an implanted vagus nerve stimulator (VNS), suggest that the family use the VNS magnet to activate the VNS and assist if required.
- To use the VNS magnet, pass the magnet closely over the VNS device; if unsuccessful, repeat every 3-5 minutes for a total of 3 times.
Note: Do not delay medication administration.
EMT-Paramedic (Standing Orders)
- Cardiac Monitor and if feasible 12 lead ECG – Manage dysrhythmias per protocol.
- If patient is in Status Epilepticus
- Midazolam 2 - 6 mg slow IV/IO/IM OR
- Midazolam 10 mg IN
- Magnesium sulfate 2-4 grams IV/IO over 5 minutes if suspect eclampsia
EMT-Paramedic (Medical Control)
Caution:
Benzodiazepines may be contraindicated in head injury or hypotension; discuss with medical control.
Note:
- Post-partum patients may experience eclamptic seizures up to several weeks after giving birth.
- Status epilepticus is defined as any generalized seizures lasting more than 5 minutes. This is a true emergency requiring rapid airway control, treatment (including benzodiazepines), and transport.