Early and aggressive treatment is crucial for the effective and efficient treatment of patients presenting with status epilepticus. This message was emphasised by presenters*at a symposium, entitled ‘Interventions in acute seizures: a focus on positive outcomes’, at the American Society for Health-System Pharmacists Annual Meeting [Minneapolis, US; June 1997]. The presenters believe that in order to improve both clinical and economic outcomes in status epilepticus: healthcare providers need to follow a predefined treatment protocol; fosphenytoin needs to play a central role in the treatment algorithm; and paramedics need to have authority to administer benzodiazepines and IM fosphenytoin in the prehospital setting.