When treating a conscious but combative patient with a seizure history, what is the most appropriate initial treatment?

In the case of a conscious but combative patient with a seizure history, ensuring the patient’s safety is paramount, which makes administering oxygen and padding the ambulance cot rails a sensible choice. While the patient may be conscious, their combative state raises the risk of self-injury, especially if they are at risk of having a seizure or if they are in the postictal phase. By providing oxygen, you support their respiratory needs, which can be compromised during a seizure due to various reasons, such as airway management or pulmonary function.

Padding the ambulance cot rails is also a critical safety measure. It helps to prevent injury during transport, especially if the patient moves erratically or if they experience additional seizures while on the cot. This approach directly addresses the immediate risks posed by the patient's behavior without escalating the situation by using physical restraints or sedation that could increase agitation or distress.

Establishing IV access and administering medications like diazepam could be indicated later in the treatment process, especially if the patient begins to experience seizures or requires chemical restraint due to prolonged agitation. However, the initial focus should always be on ensuring safety and providing basic supportive care. Similarly, while high-flow oxygen is helpful, the action of padding and securing the environment is crucial in this