RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial): A double-blind randomized clinical trial of the efficacy of intramuscular midazolam versus intravenous lorazepam in the prehospital treatment of status epilepticus by paramedics Epilepsia, 10/06/2011

Silbergleit R et al. – Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting has been shown to be associated with improved outcomes.

• RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial) is a double–blind randomized clinical trial to determine if the efficacy of IM midazolam is noninferior by a margin of 10% to that of intravenous (IV) lorazepam in patients treated by paramedics for status epilepticus (SE).
• Children and adults with>5 min of convulsions who are still seizing after paramedic arrival are administered study medication by IM autoinjector or IV infusion.
• Primary efficacy outcome is absence of seizures at emergency department (ED) arrival, without EMS rescue therapy.
• Safety outcomes include acute endotracheal intubation and recurrent seizures.
• Secondary outcomes include timing of treatment and initial seizure cessation.
• At the time of writing this communication, enrollment of all subjects is near completion and the study data will soon be analyzed.