1. Maintain airway.
2. Position the patient laterally with the head down. The head and extremities should be cushioned to prevent injury.
3. During the tonic portion of the seizure, the teeth are tightly clenched. During the clonic phase that follows, however, a bite block or other soft object should be inserted into the mouth to prevent injury to the tongue.
4. 100% O2 by mask, obtain brief history, and a fingerstick glucose.
5. Secure IV access and draw blood for serum glucose analysis. Give thiamine 100 mg IV push to prevent Wernicke's encephalopathy, then dextrose 50% 50 mL IV push.
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