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The LA Pediatric Readiness Project (LA Peds Ready) is a multi-phase quality improvement initiative which provides all Los Angeles County emergency departments(ED) the essential guidelines and resources to provide effective emergency care to children.
EDAPs are hospitals that voluntarily meet specific standards established for the care of children aged 14 years and under. The hospitals have pediatric-sized equipment and specially trained staff to address children’s unique medical needs.
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A 3 year old male is actively seizing during pre-hospital transport to the closest emergency department. Which of the following medications is considered a first line agent to help stop the seizure by paramedics?
In a child who is actively seizing, benzodiazepines are the first line agents for stoppage of seizure. If an intravenous access (IV) is available, both lorazepam and midazolam act quickly and are reasonable options to stop a seizure. When no IV is present, midazolam can be administered via the intramuscular route (IM), but lorazepam, unfortunately does not work fast and reliably enough to be given as an IM medication. It should also be noted the intranasal route (IN) is highly effective and is a reasonable first line, making answer C, the best option. Ketamine is not currently considered as a first line medication to stop seizure. Fentanyl has analgesic properties but is not used to stop seizures.