TL;DR

Seizures: Abnormal electrical activity in the brain causing involuntary movement, altered consciousness, or both. Status epilepticus > 5 minutes.

By Valenke Exam Prep Team·Last updated 2026-06-02

Seizures

NREMT EMT NREMT PARAMEDIC

Definition

Abnormal electrical activity in the brain causing involuntary movement, altered consciousness, or both. Status epilepticus > 5 minutes.

Clinical Significance

In prehospital care, understanding seizures can mean the difference between a positive patient outcome and a critical miss. An elderly woman found on the floor after a fall. Alert but confused, hip pain with external rotation and shortening of right leg. Suspect hip fracture: splint in position found, monitor for shock.

Related pharmacology: epinephrine at 1:10,000 1mg IV/IO q3-5min (cardiac arrest), 1:1,000 0.3mg IM (anaphylaxis), indicated for Cardiac arrest, anaphylaxis, severe asthma.

Patient Communication

Communication about seizures in the prehospital setting includes: explaining procedures to the patient in simple terms, obtaining informed consent when possible (implied consent for unresponsive patients), providing a calm and reassuring presence, and delivering a structured handoff report (SBAR: Situation, Background, Assessment, Recommendation) to the receiving facility.

Professional Standards

Professional standards for seizures are established by the relevant certification body and regulatory agencies. Certified professionals must demonstrate competency through examination and maintain credentials through continuing education. Scope of practice is defined by state law and facility policy. Never perform tasks outside your authorized scope.

Troubleshooting

Troubleshooting seizures in the field:

BVM: If bag-valve-mask for manual ventilation fails, verify connections, check battery, try alternate equipment. Available sizes: Adult (1500mL), Pediatric (500mL), Infant (250mL)
IO drill: If intraosseous access device for emergent vascular access fails, verify connections, check battery, try alternate equipment. Available sizes: EZ-IO: 15mm (peds), 25mm (adult), 45mm (obese)
Pulse oximeter: If measures spo2 via infrared absorption through capillary bed fails, verify connections, check battery, try alternate equipment. Available sizes: Finger clip, Earlobe, Pediatric wrap

Why It Matters

Seizure management (protect, do not restrain, time duration) tested on EMT and Paramedic exams.

Related Terms

Altered Mental Status Airway Management

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Frequently Asked Questions

What equipment is needed for managing seizures in the field?▼

For seizures: Pulse oximeter provides Measures SpO2 via infrared absorption through capillary bed. AED provides Automated external defibrillator for VF/pVT. King airway provides Supraglottic blind-insertion airway device.

What medications are commonly associated with seizures?▼

For seizures: epinephrine: 1:10,000 1mg IV/IO q3-5min (cardiac arrest), 1:1,000 0.3mg IM (anaphylaxis), route IV/IO, IM, ET, for Cardiac arrest, anaphylaxis, severe asthma. adenosine: 6mg rapid IV push, then 12mg if needed, route IV rapid push with flush, for SVT (narrow complex tachycardia).

What assessment tools help evaluate seizures?▼

For seizures: Trauma Score: evaluates GCS, Systolic BP, Respiratory rate; scoring is Revised Trauma Score: coded values 0-4, sum correlates with survival probability. Glasgow Coma Scale: evaluates Eye opening (1-4), Verbal response (1-5), Motor response (1-6); scoring is 3-15, 8 or less = severe, 9-12 = moderate, 13-15 = mild.