RAMPART
Intramuscular versus Intravenous Therapy for Prehospital Status Epilepticus
Patient / Population Intervention / Exposure Comparison Outcome
In 893 patients with prehospital status epilepticus, intramuscular midazolam 10 mg was non-inferior and superior on seizure cessation by ED arrival versus intravenous lorazepam 4 mg.
N
893
Design
Double-blind double-dummy RCT, US NETT
Endpoint
Seizure cessation before ED arrival
Relevance
2
Result73.4% vs 63.4% (Δ 10%; 95% CI 4.0–16.1; p<0.001 for non-inferiority and superiority).
Silbergleit R, et al. N Engl J Med. 2012;366(7):591-600. 10.1056/NEJMoa1107494
Discussion & critique
IM midazolam (autoinjector) is the prehospital first-line when no rapid IV access.