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Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.  

The First nonfebrile seizure synopsis provides a high level overview of the care standards employed for this Clinical Pathway. 

Algorithms associated with this Clinical Pathway: 

Inclusion and exclusion criteria for the first nonfebrile seizure

Inclusion criteria:  

  • Children 2 to 18-year-old presenting after a first-time unprovoked, nonfebrile seizure.

Exclusion criteria: 

  • Children with ongoing seizure activity when they are admitted to the ED.
  • Children who were treated with a medication by emergency medical services (EMS).
  • Children with atonic or myoclonic seizures.
  • Children who are in status epilepticus.

Committee members involved in the development of the: 

  • First Seizure Management in the ED/UCC CPG 
  • B. Zuccarelli MD | Neurology Fellow | Committee chair 
  • A. D’Angelo MD | Emergency Medicine | Committee member 
  • A. Loehr, RN | Emergency Department | Committee member 
  • B. Burghardt MD | General Pediatrics | Committee member 
  • E. Dague RN, CPNP | Emergency Department and Urgent Care | Committee member 
  • M. Goeden MD | Pediatric Resident, Neurology | Committee member 
  • Ara Hall MD | Neurology | Committee member 
  • J. Wiebe, RN, CPN, SANE-A, SANE-P, Director, Emergency Department Nursing | Committee member 
  • A. Montalbano, MD, MPH, QBS | Urgent Care | Committee member 
  • I. Siddiqi PharmD | Pharmacy | Committee member  
  • J. Michael DO | Evidence Based Practice & Emergency Medicine | Committee member 
  • J. Bartlett PhD, RN | Director, Evidence Based Practice | Committee member 
  • N. Allen MS, MLS, RD, LD | Evidence Based Practice | Committee member 
  • J. Dusin MS, RD, LD, CNSC | Evidence Based Practice | Committee member 

Publication dates: 

  • Finalized date:  
  • First Seizure Management: June 16, 2016 
  • Next expected revision date: Due for revision.

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These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.