It’s 2:30 pm on Saturday. Your event is going brilliantly. The sun’s out, the crowds are happy, everything’s running smoothly.
Then someone collapses. They’re having a seizure. You’re facing an event medical emergency.
What happens next depends entirely on the type of event medical cover you’ve booked.
Let’s walk through two versions of this event medical emergency. Same scenario. Same seizure. But two very different outcomes.
The Event Medical Emergency: A Seizure Scenario
You’re running a local rugby tournament. 500 competitors, 2,000 spectators. A 28-year-old player comes off the pitch after a tackle. He seems fine initially, then suddenly collapses and starts having a seizure.
His teammates are panicking. Parents are watching. Your event medical team rushes over.
Now let’s see what happens with two different types of event medical cover when someone has a seizure at your event.
Version 1: The Self-Employed Paramedic (No CQC Registration)
Minute 1: The Response
Your event medical cover arrives quickly. It’s a single paramedic you found through a Facebook group. He’s experienced, professional, and knows what he’s doing clinically.
He assesses the situation. Classic tonic-clonic seizure. The player is convulsing, unresponsive, at risk of injury.
Minute 2: The Protocol
The paramedic knows the protocol for a seizure at an event:
- Protect the patient from injury
- Time the seizure
- Prepare to manage the airway if needed
- If the seizure lasts more than 5 minutes, administer emergency medication
He does everything right for the first four steps. He clears the area, cushions the player’s head, times the seizure, and monitors his airway.
Minute 5: The Problem
The seizure hasn’t stopped. It’s been five minutes now. NICE guidelines are clear: this event medical emergency now requires immediate medication.
This is now status epilepticus—a life-threatening emergency. The risk of permanent brain damage increases with every passing minute. The risk of death is significant.
The player needs buccal midazolam or rectal diazepam to stop the seizure. Now.
Your paramedic knows this. He’s administered it dozens of times in his NHS career. He knows exactly what to do.
But he doesn’t have it.
Why? Because he’s self-employed, not working under a CQC-registered organisation. He can’t access Patient Group Directions (PGDs). He can’t legally purchase or carry these medications.
Minute 6: The Wait Begins
The paramedic calls 999. He’s calm but urgent. The call handler recognises this immediately: Category 1 emergency—the most life-threatening classification there is.
An ambulance is available. It’s dispatched immediately, blue lights and sirens.
Estimated arrival time: 20 minutes.
Not because there’s a major incident. Not because resources are stretched. Simply because your rugby club is rural, and the ambulance has to physically travel from the nearest station.
Yes, they’re using blue lights and sirens. Yes, they’re going as fast as safely possible. But lights and sirens only reduce journey time by about 10%. Physics doesn’t care about emergencies. The ambulance still has to cover 15 miles of country roads.
Twenty minutes. For a condition where every minute counts.
Minute 7-25: The Deterioration
The seizure continues. Your paramedic is doing everything within his capability:
- Managing the airway
- Administering high-flow oxygen
- Monitoring vital signs
- Positioning to prevent aspiration
- Constant reassurance to the family (though the player can’t hear him)
But without the medication to stop the seizure, he’s fighting a losing battle.
And now there’s another problem: oxygen.
The standard portable oxygen cylinder he’s carrying has about 30 minutes of high-flow oxygen. He’s already used 7 minutes. If the ambulance doesn’t arrive soon, he’ll run out. Then what? Does he reduce the oxygen flow to make it last longer, compromising the patient’s care? Does he switch to his backup cylinder (if he even has one), knowing that won’t last either?
The risks are mounting with every minute:
- Brain damage: After 5 minutes of continuous seizure activity, neurons begin to die
- Hypoxia: Despite oxygen therapy, prolonged seizure activity affects oxygen delivery to the brain
- Aspiration: Risk of vomiting and inhaling stomach contents
- Cardiac complications: The physical strain of prolonged seizure activity
- Rhabdomyolysis: Muscle breakdown from continuous convulsions
- Hyperthermia: Body temperature rising dangerously
- Death: Status epilepticus has a mortality rate of 10-20%, even with treatment
The crowd is watching. Parents are filming on phones. The player’s family is distraught, asking “Why can’t you give him something? Why can’t you stop it?”
Your paramedic has to explain: “I can’t. I don’t have the medication. The ambulance is coming.”
At minute 20, he’s watching his oxygen gauge drop. He’s making impossible calculations: reduce the flow now to make it last, or keep it high and hope the ambulance arrives in the next 10 minutes?
Your event has stopped. Everyone’s focused on this one terrifying scene. A young man having a seizure on the ground for over 20 minutes while everyone waits, and the medical team is running out of oxygen.
Minute 26: The NHS Ambulance Arrives
Finally—finally—the NHS ambulance arrives. They’ve driven as fast as safely possible, but they can’t teleport.
They administer buccal midazolam immediately. Within two minutes, the seizure stops.
The player has been seizing for over 25 minutes. He’s post-ictal, deeply unconscious, and needs immediate hospital care. There’s a real possibility of permanent neurological damage. The next 24-48 hours will be critical.
He’s blue-lighted to hospital, where he’ll spend days in intensive care.
The Aftermath
- Your event was disrupted for over 40 minutes
- The incident is all over social media within the hour: “Player has seizure for 25 minutes at rugby tournament—why couldn’t they stop it?”
- The player’s family is asking hard questions: “Why didn’t your medical team have the medication? Why did we have to wait so long?”
- Your insurance company is asking even harder questions about your event medical cover
- Local news picks up the story: “Life-threatening delay at rugby tournament raises questions about event medical standards”
- The player survives, but with potential long-term neurological effects from the prolonged seizure
- Other events start asking: “Should we still book them? What if this happens at our event?”
- You’re facing potential legal action from the player’s family
Your paramedic did everything he could within his limitations. He was professional, competent, and caring. But those limitations—the inability to access the medication that could have stopped the seizure at 5 minutes instead of 25 minutes—had potentially life-changing consequences.
This wasn’t about skill. This was about systems, governance, and legal authority to carry the medications that save lives.
Version 2: The CQC-Registered Event Medical Provider
Let’s rewind. Same event medical emergency, but this time you’ve booked a CQC-registered event medical provider like Marches Ambulance Service.
Minute 1: The Response
Your event medical team arrives quickly. It’s a paramedic working under full clinical governance, with access to comprehensive equipment and medications.
She assesses the situation. Classic tonic-clonic seizure at an event. She knows exactly what to do.
Minute 2: The Protocol
Same initial steps for managing a seizure at an event:
- Protect the patient from injury
- Time the seizure
- Monitor airway and breathing
- Prepare medications in case the seizure doesn’t stop
But this time, there’s a crucial difference: she has the medications ready.
She’s already drawn up buccal midazolam, checking the dose, preparing for administration if the seizure reaches 5 minutes.
Minute 5: The Intervention
The seizure hasn’t stopped. It’s been five minutes. This is now status epilepticus—a life-threatening emergency.
No waiting. No calling 999. No hoping an ambulance arrives in time.
The paramedic administers buccal midazolam immediately, under her organisation’s Patient Group Direction. It’s legal, it’s appropriate, and it’s exactly what the clinical guidelines recommend.
Treatment time from seizure onset: 5 minutes.
Minute 7: The Resolution
The seizure stops. The medication has worked.
The player is post-ictal (drowsy and confused, which is normal after a seizure) but his airway is clear, he’s breathing well, and the seizure has stopped.
Total seizure duration: 7 minutes. Brain damage risk: minimised. Life-threatening emergency: resolved.
The paramedic continues monitoring. She checks his vital signs, ensures he’s recovering appropriately, and makes a clinical decision about whether he needs hospital transport.
Minute 15: The Clinical Decision
The player is now alert enough to talk. The paramedic takes a full history:
- Does he have epilepsy? (No, first seizure)
- Any head injury during the game? (Yes, significant tackle just before)
- Any other medical history? (None)
Given it’s his first seizure and it followed a head impact, he needs hospital assessment. Your event medical provider has a CQC-registered ambulance on-site. They can transport him directly, with full clinical care en route, monitoring for any complications.
No waiting for 999. No tying up NHS resources. No 20-minute wait for an ambulance to travel from the nearest station. Seamless, professional care from start to finish.
Minute 30: Back to Normal
The player is safely on his way to hospital with his family. Your event medical team has cleared the scene, reassured spectators, and your tournament continues.
The player will be thoroughly assessed at hospital, but because the seizure was stopped quickly, his prognosis is good.
The Aftermath
- Total disruption time: 15 minutes
- The player received life-saving medication within 5 minutes of the emergency threshold
- His family is grateful: “Thank God they had what they needed. They saved him.”
- Your insurance company is satisfied you had proper, CQC-registered medical cover
- Social media comments praise your event’s rapid, professional medical response
- Other organisers ask: “Who did you use for medical cover? We want the same level of care.”
- The player makes a full recovery with no neurological damage
Same emergency. Same initial presentation. The difference? 20 minutes of life-threatening seizure activity versus immediate, appropriate treatment.
That difference could be the difference between full recovery and permanent brain damage. Between life and death.
Why This Difference Matters for Event Medical Emergencies
The difference between these two scenarios isn’t about the skill or experience of the individual clinician. Both paramedics knew what to do. Both were competent, professional, and trying their best.
The difference is about systems, governance, and legal authority.
What the CQC-Registered Event Medical Provider Had:
- Patient Group Directions – Legal authority to supply and administer emergency medications for seizures
- Proper medication stock – Buccal midazolam legally sourced, correctly stored, readily available
- Clinical governance – Protocols, oversight, and accountability
- Comprehensive equipment – Everything needed for emergency care including adequate oxygen supplies
- Transport capability – CQC-registered ambulance for direct hospital transfer
- Insurance – Full cover for all clinical interventions
- Accountability – Regulated, inspected, and held to standards
What the Self-Employed Paramedic Didn’t Have:
- No PGDs – Couldn’t legally carry the seizure medications
- No medication stock – Even if he wanted to, he couldn’t purchase them legally
- No clinical governance – Working alone without organisational support
- Limited equipment – Only what he could personally afford and transport
- Limited oxygen – Standard cylinder running out during prolonged emergency
- No transport capability – Had to wait for NHS ambulance
- Questionable insurance – May not cover all scenarios
- No accountability – No regulatory oversight
The patient paid the price for that difference.
This Isn’t Just About Seizures at Events
Seizures are just one example. The same event medical emergency pattern plays out with other conditions:
Severe Asthma Attacks
- Without PGDs: Can’t administer nebulised salbutamol or ipratropium bromide. Wait for NHS ambulance while the patient struggles to breathe.
- With PGDs: Immediate nebuliser therapy, patient improves within minutes.
Anaphylaxis
- Without proper cover: May have one EpiPen, but what if the patient needs a second dose? What about IV fluids, antihistamines, steroids?
- With proper cover: Full anaphylaxis protocol, multiple medication options, comprehensive treatment.
Major Trauma with Bleeding
- Without PGDs: Can’t administer Tranexamic Acid (TXA), which reduces mortality by up to 30% when given early.
- With PGDs: TXA administered immediately, bleeding controlled, better outcomes.
Cardiac Chest Pain
- Without proper medication access: Can’t give GTN spray (purchasing problem), limited pain relief options.
- With proper cover: Full cardiac protocol, appropriate medications, ECG monitoring, direct hospital transfer.
Every emergency has the same pattern: proper event medical cover makes the difference between immediate, appropriate treatment and waiting while the situation deteriorates.
“But Seizures at Events Are Rare, Right?”
You might be thinking: “This is an extreme scenario. How often does someone have a seizure at an event?”
At any event with significant numbers, an event medical emergency like a seizure is a realistic possibility.
Epilepsy Action reports that 1 in 100 people in the UK has epilepsy. At an event with 2,000 people, that’s statistically 20 people who have epilepsy.
Most of them will be well-controlled on medication. But seizures can be triggered by:
- Stress and excitement
- Lack of sleep (common at multi-day events)
- Alcohol consumption
- Flashing lights
- Physical exertion
- Head injuries (especially at sports events)
- Missing medication doses
And that’s just epilepsy. First-time seizures at events can also be caused by:
- Head injuries
- Heatstroke
- Low blood sugar
- Alcohol or drug use
- Infections
- Stroke
At any event with significant numbers of people, a seizure is a realistic possibility.
The question isn’t “will someone have a seizure at my event?” It’s “when someone has a seizure at my event, can my event medical cover actually help?”
What High-Risk Events Need When Someone Has a Seizure
If you’re running high-risk events, rugby, football, equestrian, motorsport, boxing, martial arts the stakes are even higher.
These events have increased risk of:
- Head injuries leading to seizures
- Major trauma requiring immediate medication
- Cardiac events from extreme exertion
- Serious bleeding requiring TXA
You cannot afford to have event medical cover that can’t respond appropriately when someone has a seizure at your event.
Imagine explaining to a competitor’s family that your medical provider couldn’t administer the medication that might have prevented brain damage. Imagine the insurance investigation. Imagine the headlines.
Now imagine the alternative: proper, CQC-registered event medical cover that can respond immediately with the right medications, the right equipment, and the right clinical governance.
Which would you rather have?
The Cost Question
“CQC-registered event medical providers cost more,” you’re thinking.
Yes, they do. Let’s be honest about that.
A self-employed paramedic might charge £25-35 per hour. A CQC-registered provider might charge £40-50 per hour (or more, depending on the event requirements).
For an 8-hour event, that’s a difference of £120-200.
Now let’s talk about the other costs when someone has a seizure at your event:
If something goes wrong with inadequate event medical cover:
- Legal liability: £tens of thousands to £millions
- Insurance premium increases: £thousands per year
- Reputational damage: loss of future bookings, sponsors pulling out
- Regulatory action: fines, license restrictions
- Personal guilt: priceless
Versus the cost of proper cover:
- An extra £120-200 for the event
- Peace of mind: priceless
- Proper protection: priceless
- Professional response when it matters: priceless
Which is the better investment?
What You Should Be Asking About Seizure Response
When you’re booking event medical cover, don’t just ask “how much?” ask about their event medical emergency response capabilities:
1. “Do you operate under Patient Group Directions?”
If no, they can’t administer critical emergency medications for seizures.
2. “What medications do you carry for seizures?”
Specifically ask about: buccal midazolam, rectal diazepam. If they don’t have these, they can’t treat prolonged seizures.
3. “Can you show me your PGD documentation?”
A legitimate provider will have comprehensive PGDs and will share them (within confidentiality limits).
4. “What happens if someone has a prolonged seizure at my event?”
Listen to their answer. Do they have immediate treatment available, or do they wait for NHS backup?
5. “Are you CQC-registered for treatment of disease, disorder, and injury?”
Not just transportation. Actual treatment.
6. “How much oxygen do you carry?”
For a prolonged emergency, do they have adequate supplies?
7. “What’s your response protocol for seizures at events?”
They should be able to articulate clear protocols based on NICE guidelines.
8. “Do you have transport capability, or do we wait for NHS ambulances?”
Waiting for 999 in a rural location could mean 20-30 minute delays.
The Bottom Line
When you face an event medical emergency like a seizure at your event, you want cover that can:
- Respond immediately
- Administer appropriate medication within 5 minutes
- Provide comprehensive clinical care
- Have adequate oxygen and equipment for prolonged emergencies
- Transport to hospital if needed
- Do all of this legally, safely, and professionally
You don’t want event medical cover that has to stand there, watching someone seize for 20+ minutes, running out of oxygen, waiting for an NHS ambulance because they don’t have legal access to the medications that could stop it.
At Marches Ambulance Service, we’re a CQC-registered event medical provider with comprehensive PGDs. Our teams carry buccal midazolam, adequate oxygen supplies, and a full range of emergency medications.
When someone has a seizure at your event, we can treat them immediately. Not in 20 minutes. Not when the NHS ambulance arrives. Immediately.
No subcontractors. No surprises. No waiting while emergencies deteriorate.
Can your current event medical cover say the same?
Want to know what medications and capabilities your event medical cover should have? Download our free guide: “The Event Organiser’s Guide to Medical Cover” or get in touch: hello@marchesambulance.co.uk
