What is the most appropriate recommendation for a child actively seizing for 10 minutes?

In managing a child who has been actively seizing for 10 minutes, prompt intervention is critical to prevent potential complications such as status epilepticus. The administration of IV lorazepam is a recognized first-line treatment for terminating prolonged seizures due to its rapid efficacy and safety profile. Lorazepam acts quickly to enhance the effects of the neurotransmitter gamma-aminobutyric acid (GABA), leading to sedation and cessation of seizure activity.

While other medications such as rectal diazepam can also be used for seizure management, they are generally indicated for initial seizure control in a pre-hospital or non-emergency setting rather than in a scenario where the seizure has already lasted as long as 10 minutes. Additionally, IV fosphenytoin is effective for seizure management but is typically used as a second-line agent after the initial seizure has been controlled, and it takes longer to administer than lorazepam. Rectal acetaminophen is not appropriate in this context as it does not have an anti-seizure effect.

In emergency situations with sustained seizure activity, IV lorazepam provides the quickest and most effective response, making it the most appropriate recommendation in this case.