Active Seizure / Status Timeline

• >2–3 min: abort seizure (order one PRN, check AED levels, contact primary)

• 0 min (IV access): Lorazepam 4 mg IV or Midazolam 5 mg IV

• 0 min (no IV): Midazolam 10 mg IM once

• 5 min: repeat Lorazepam 4 mg IV or Midazolam 5 mg IV if still seizing ( call Neurology)

• 10 min: if ongoing → Levetiracetam (Keppra) 40–60 mg/kg, max 4.5 g + call Neurology (ideally earlier)

• >10–20 min / refractory: ICU, continuous Midazolam (Versed drip), intubate for airway protection / GCS <8, consider Propofol infusion