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Ricky is a 3-year-old boy with no significant medical history who is brought to the emergency department (ED) by emergency medical services (EMS) for an episode of shaking and unresponsiveness at home. EMS reports that on their arrival, Ricky was observed having whole body stiffening and shaking lasting approximately 5 minutes, for which he received 1 dose of intramuscular midazolam. From the descriptions of Ricky’s parents and EMS, the ED physician determines that the episode is consistent with a seizure. Ricky has been observed in the ED for approximately 3 hours without further seizure activity. Though still drowsy, he does sit up briefly and takes a few sips of juice before falling back asleep. The ED physician contacts you to request that you evaluate Ricky for admission.

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