Overview
What is RAMPART?
Seizures are a common medical problem. Most seizures are brief and stop by themselves, but those that don’t stop in seconds or minutes are a dangerous life-threatening medical emergency. Paramedics often have medications that can stop the seizures, but the best way to give them is not known.
The Rapid Anticonvulsant Medications Prior to Arrival Trial (RAMPART) was a research study to figure out whether giving anti-seizure medicine worked better and more quickly when given through an IV or when given as a shot in the muscle. Two similar medicines – midazolam and lorazepam – were used. Both were already used by paramedics in the field and by doctors in the hospital to stop seizures. Lorazepam is commonly given IV, and midazolam is commonly given as a shot in the muscle.
Why did we do this study?
The purpose of this study was to find out which type of routine care is the best way for paramedics to stop someone from seizing.
Who was involved?
This study involved people who were having seizures that were not stopping by themselves. Paramedics enrolled individuals who were still seizing when they arrived and who had been seizing for more than 5 minutes. They were only enrolled if the hospital to which they were going to be taken by ambulance was a participating hospital in the study. People with seizures were NOT enrolled if their seizure was caused by hitting their head or low blood sugar. They were NOT enrolled if they were known to be allergic to either of the antiseizure medicines used in the study, if their heart was beating very slowly, if they were known to be pregnant or if they were in jail or prison. Those with a Medic Alert tag that included the phrase “RAMPART declined” were also not enrolled.
What made RAMPART different from other research studies?
Unlike most research studies, the individual participating in RAMPART was not able to provide permission or consent before treatment was given because he/she was having a seizure and was unconscious. Therefore, RAMPART was conducted under federal rules that allow for exception from informed consent (EFIC) for emergency research studies. Click here for more information regarding these special rules.