Initial Steps for Stabilisation Call for help to remove/control hazards ABCDE assessment Cardiopulmonary resuscitation if needed Basic airway maneuvers & start O2 therapy Place patient in recovery position Gains to protect airway of an unconscious patient without a spinal injury Place patient in lateral decubitus position with slight neck extension to their extremities arranged to stabilize them to prevent rolling into a supine or prone position. Phase-based acute seizure management If contact is ≥ 5 mins from seizure onset or the time from seizure onset is unknown implement interventions for early seizures & early status epilepticus simultaneously. Early seizure 0-5 min -> usually self-limiting * No pharmacotherapy indicated * administer PR dose Early status epilepticus -> 5 - 20 min * repeat every 5-10 min if no response * administer loading dose * IV benzos acts on GABA-A-R * IV midazolam if IV access is not available Resistent status epilepticus -> 20-40 min * 2nd line * IV fosphenytoin -> prolongs inactivation of Na+ voltage gated channels * IV valproic acid * IV levetiracetam -> binds to synaptic vesicle protein 2A