Sweeping changes to the National Standard Curriculum in 1994 allowed EMT-Basics to assist patients with self-administration of lifesaving rescue medications. Prior to 1997, no rescue medication was available for a life-threatening condition like status epilepticus or prolonged seizure activity. The development of Diastat® in the mid-1990s has provided an easily administered, efficient and safe method of treating prolonged seizure activity. Given the safety and efficacy of this medication and procedure, it is the next logical step in the expanding scope of practice for EMT-Basics and should be added to the approved list of assisted rescue medications contained in the next revision of the National EMS Education Standards and Instructional Guidelines.

   In 1994, the National Highway Traffic Safety Administration released its revised National Standard Curriculum for EMT-Basics, with a number of new cognitive and manipulative skill sets that included assisting patients with the self-administration of prescribed rescue medications like nitroglycerin, oral glucose, inhalers and epinephrine auto-injectable pens. The rationale behind basic level-assisted administration was that the patient had already been evaluated by a physician and prescribed the medications for self-administration. Second, the benefit of timely administration of these prescribed medications far outweighed any inherent risks that could be recognized in the prehospital setting. Strict guidelines and protocols have been attached to these new responsibilities, which continue to be outlined in the 2009 National EMS Education Standards and Instructional Guidelines.

Diazepam Use in Seizures

   Diastat®--diazepam rectal gel and its trademark administration system-- was first approved for use by the Food and Drug Administration in the United States in 1997 as a treatment for breakthrough seizures in adults and children over age 2. This Schedule IV CDS is currently the only FDA-approved treatment for status epilepticus (SE) or other life-threatening seizures in this age group.¹ It was specifically developed for use by parents, caregivers and other nonmedical personnel, and is therefore designed to be easy and safe to administer outside a clinical setting.²