An unresponsive 2-month-old has a single seizure that lasted about two minutes. The child then has another generalized seizure. What should you do first?

• A. Assess vital signs
• B. Begin transport
• C. Insert an oropharyngeal airway
• D. Apply a cervical collar

Answer: (B)

When a two-month-old is unresponsive and having repeated seizures, the priority is rapid transport to a pediatric-capable facility. This situation can represent status epilepticus or another serious, time-sensitive problem (infection, metabolic disturbance, intracranial pathology). Getting the child to advanced care quickly allows lifesaving treatments to be given promptly and appropriate workup to begin.

In the meantime, keep the airway protected and monitor breathing. Avoid delaying transport to perform procedures that aren’t immediately necessary during active convulsions—such as inserting an oropharyngeal airway or immobilizing the neck with a collar—unless there is a clear trauma indication. On scene, protect the child from injury, suction secretions if needed, ensure a patent airway, give oxygen if indicated, and start transport. En route, continue airway monitoring and be prepared to assist ventilation if the child’s breathing becomes inadequate.