- *Signs and Symptoms of an Active Seizure** - Altered mental status - Tonic/clonic movements - Incontinence - Seizure activity - Evidence of trauma - Unconsciousness - Tongue biting - Blank stare - Rhythmic facial movements【4:0†source】. - *References** - San Mateo County Emergency Medical Services, Seizure – Active Protocol【4:0†source】.

- *Dosage** - Initial dose of adenosine: 0.1 mg/kg - For a 10 kg child: - Dose = 0.1 mg/kg × 10 kg = 1 mg - Administer 1 mg (0.34 ml of 3 mg/ml solution)【4:3†pediatric_dosing_guide.pdf】. - *Administration Steps** - Immediately follow the administration with a rapid 10-20 ml normal saline (NS) bolus【4:3†pediatric_dosing_guide.pdf】. - *Monitoring** - Monitor the patient's heart rate and rhythm after administration for effect【4:12†pediatric_dosing_guide.pdf】. - *Transport Destination** - Ensure that transport is to a facility capable of managing pediatric tachyarrhythmias【4:11†pediatric_dosing_guide.pdf】. - *References** - San Mateo County Pediatric Dosing Guidelines【4:3†pediatric_dosing_guide.pdf】.

- *Dosage

- *Dosage

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- *Dosage** - Epinephrine 1:1,000 (1 mg/1 ml) IM: 0.3 mg - May repeat x 1 after 5 min if no improvement - Epinephrine 1:10,000 IV: Use if hypotensive or no improvement after two (2) doses of IM - If needed, administer 0.1 mg slow IV/IO - *Administration Steps** - IM epinephrine should be administered as priority before or during IV or IO access attempts. - Continuous monitoring of vital signs and symptoms is essential. - *Monitoring** - Monitor patient closely after administration for improvement or adverse reactions. - Ensure continuous EtCO2 measurement for patients with respiratory symptoms. - *Contraindications / Precautions** - Use caution in patients with a history of hypertension or coronary artery disease. - Be aware of potential serious dysrhythmias or exacerbating angina from epinephrine use. - *Transport Destination** - Transport to an appropriate facility for further management of anaphylaxis. References: - 2025 Adult Drug Reference - San Mateo County 2025 Field Treatment Guidelines【4:1†adult_dosing_guide.pdf】.

- *Dosage** - Epinephrine 1:1,000 (1 mg/1 ml) IM - Initial dosing: 0.3 mg to 0.5 mg IM - May repeat x1 after 5 minutes if no improvement - *Administration Steps** - Administer IM Epinephrine as priority before or during attempts at IV or IO access. - If hypotensive or no improvement after initial IM dosing, may consider Epinephrine 1:10,000 IV for greater effect. - *Caution** - Use with caution in patients with a history of hypertension or coronary artery disease due to potential for serious dysrhythmias【4:3†source】【4:7†source】【4:9†source】【4:10†source】【4:11†source】. - *Monitoring** - Adult patients who receive Epinephrine should receive a 12-Lead ECG at some point during their care. - All patients with respiratory symptoms must have continuous EtCO2 measurement【4:7†source】【4:8†source】. - *References** - San Mateo County Emergency Medical Services Treatment Guidelines: 2025 Adult Drug Reference - San Mateo County Emergency Medical Services Anaphylaxis Protocol【4:7†source】【4:9†source】.

- *Dosage** - Midazolam: Administer Im if patient is actively seizing. - *Administration Steps** - If IV or IO access is not established, give Midazolam IM. - Do not delay administration to obtain IV or IO access while the patient is in active seizure. - *Monitoring** - Continuous cardiac monitoring is required. - Monitor EtCO2. - *Contraindications / Precautions** - Be prepared for airway problems and continued seizures. - Have equipment ready to assist with ventilations. - *Transport Destination** - Notify receiving facility of the patient's condition. - Consider Base Hospital for medical direction if necessary. References: - San Mateo County Emergency Medical Services, Seizure – Active Treatment Protocol A30【4:0†source】.

- *Dosage** - Midazolam: 5 mg IM (repeat twice to a maximum of 10 mg) if the patient is actively seizing upon EMS arrival. - If IV/IO access is established: Midazolam: 5 mg IV (may repeat once after 10 minutes if needed)【4:0†source】【4:1†source】. - *Administration Steps** - If the patient is actively seizing and does not have IV access, administer Midazolam IM; do not delay for IV/IO access【4:0†source】【4:1†source】. - Establish cardiac monitoring and IV/IO if possible【4:0†source】. - *Monitoring** - Continuously monitor the patient for effectiveness of medication and signs of respiratory depression following Midazolam administration【4:0†source】【4:1†source】. - *Transport Considerations** - Early transport is advised if the seizure lasts more than 5 minutes or if there are repeated seizures【4:0†source】. - *References** - San Mateo County Emergency Medical Services treatment protocols for seizures【4:0†source】【4:1†source】.

- *Dosage** - Administer 2.5 mg of Albuterol (0.83% solution) via nebulizer for adults. - Alternatively, use 90-180 mcg (2-4 puffs) from an Albuterol metered-dose inhaler (MDI) with a spacer. - *Administration Steps** - Ensure proper oxygen supply and equipment setup. - Administer Albuterol via nebulizer or MDI as indicated. - *Monitoring** - Continuous monitoring of vital signs and oxygen saturation (SpO2) is required. - Assess respiratory status frequently during and after medication administration. - *Contraindications / Precautions** - Consider patient's history of cardiovascular disease, which may be influenced by beta-agonist medications. - *Transport Destination** - Consider transport to an appropriate facility for further evaluation and management if the patient does not improve. References: - San Mateo County Emergency Medical Services, 2025 Field Treatment Guidelines【6:1†source】.