Emergency Medical Minute Episode 964: Ketamine & Midazolam for Prehospital Seizure Management
Jul 7, 2025
Discover the intriguing world of prehospital seizure management, focusing on the roles of midazolam and ketamine. A recent study reveals that combining ketamine with midazolam significantly increases the chances of halting seizures before reaching the hospital. The findings show an impressive 94.4% resolution rate for patients receiving both medications, compared to 82% for those on midazolam alone. Delve into the implications of these results and examine the potential limitations of the study in this exciting discussion.
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Ketamine's Role in Seizure Control
- Ketamine is a potent NMDA antagonist that could help control seizures theoretically.
- A Florida EMS study showed ketamine added after midazolam improved seizure resolution before hospital arrival.
Midazolam Plus Ketamine Improves Control
- Midazolam alone stopped seizures in about 82% of patients before ED arrival.
- Combining midazolam then ketamine stopped seizures in 94.4%, a significant improvement.
Use Ketamine for Refractory Seizures
- Consider ketamine if seizures persist after initial medications like midazolam.
- Ketamine can be a useful addition for refractory seizures prehospital as data shows promise.