During a shift you are dispatched to a 17-year-old female patient seizing. Although the underlying cause of a seizure can be relatively complex, being dispatched to a seizure is a rather standard callout for most paramedics. Central nervous system (CNS) depressants such as midazolam or diazepam are a front-line drug that most ambulances services utilize to reduce the seizing patient before a short transport to hospital.1 However, consider the difference in the case pathology if the CNS depressants you have don’t work, or there are very limited transport options, or the hospital is an ocean away?