2024 ACEP Adult Patients Presenting to the Emergency Department with Seizures Guidelines Summary - Guideline Central
Summary of Recommendations
Document Overview

Adult Patients Presenting to the Emergency Department With Seizures

American College of Emergency Physicians


Publication Date: Apr 18, 2024

Page Last Updated: May 5, 2026

Level of Recommendation

Recommendation Level
LevelDefinition
AGenerally accepted principles for patient care that reflect a high degree of clinical certainty
BRecommendations for patient care that may identify a particular strategy or range of strategies that reflect moderate clinical certainty
CRecommendations for patient care that are based on evidence from Class of Evidence III studies or, in the absence of adequate published literature, based on expert consensus

Document Overview

Document Title
Management of Adult Patients Presenting to the Emergency Department with Seizures
Authoring Society

American College of Emergency Physicians

Document Publication Date
Apr 18, 2024
Page Last Reviewed/Updated
May 5, 2026
Document Type
Guideline
Country of Publication
United States
Full Text Freely Available
No
Full Text Guideline
www.doi.org/10.1016/j.annemergmed.2024.02.018

Document Scope, Criteria, and Use Cases

Document Objectives

This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of adult emergency department patients presenting with seizure. A writing committee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical question: In emergency department patients with generalized convulsive status epilepticus who continue to have seizures despite receiving optimal dosing of benzodiazepine, which agent or agents should be administered next to terminate seizures? Evidence was graded, and recommendations were made based on the strength of the available data.

Scope
Management, Treatment
Diseases/Conditions (MeSH)

D012640 - Seizures

D004635 - Emergency Medicine

D020270 - Alcohol Withdrawal Seizures

D003294 - Seizures, Febrile

D003295 - Convulsive Therapy

D003292 - Convulsants

D012640 - Seizures

D004635 - Emergency Medicine

D020270 - Alcohol Withdrawal Seizures

D003294 - Seizures, Febrile

D003295 - Convulsive Therapy

D003292 - Convulsants

Keywords
adult seizure, seizure, unprovoked first seizure
Target Patient Population
Adult patients aged 18 years and older presenting to the emergency department with generalized convulsive seizures
Target Provider Population
Physicians working in emergency departments
Inclusion Criteria
Male, Female, Adolescent, Adult, Older Adult
Health Care Settings
Emergency Care, Medical Transportation
Intended Users
Nurse, Nurse Practitioner, Paramedic/EMT, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents
15
Includes peer/external review process?
Yes
Includes public comment process?
No
Methodologist involvement?
Yes
Patient involvement?
No
Includes multi-disciplinary group?
Yes
Includes systematic review?
Yes
Grades quality of strength of evidence?
Yes
Grades quality of strength of recommendation?
Yes
Includes benefits/harms analysis with recommendations?
No
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