Children with epilepsy frequently experience breakthrough seizures at home, in school, or in the community that are prolonged or in clusters. Although all patients with epilepsy warrant a systematic, evidence-based, drug rescue plan for breakthroughs outside the hospital, do pediatric epileptologists prescribe in a consistent approach? In this volume of The Journal Wallace et al present results from 36 experts from the Pediatric Epilepsy Consortium queried about which medications they prescribe for breakthroughs in various situations for developmentally delayed or developmentally typical children of various ages. Among pediatric epileptologists, rectal diazepam was the most frequently chosen drug for prolonged seizures in the community across all age groups, except in developmentally typical teenagers, for whom off-label intranasal midazolam was preferred, whereas for seizure clusters, oral disintegrating clonazepam was most recommended except in young children. Although this study surveyed only a small sample, the results clearly highlight the lack of a consistent rescue plan for seizure breakthroughs in children outside a hospital. A number of factors may be to blame: lack of clinical trials and FDA-approved therapeutic options, legislative inconsistencies between jurisdictions, variable professional practice guidelines, and potential liability issues. Regardless, this wide variation in prescribing patterns for abortive rescue medications outside the hospital provides an opportunity for improvement and consensus. Epileptologists will need to continue working with parents, schools, legislators, and pharma to develop consistent approaches that are most efficacious, limit side effects, decrease hospitalizations, and preserve patient dignity. Article page 111▸ Seizure Rescue Medication Use among US Pediatric Epilepsy Providers: A Survey of the Pediatric Epilepsy Research ConsortiumThe Journal of PediatricsVol. 212PreviewTo assess how pediatric neurologists prescribe home seizure rescue medications to treat acute prolonged seizures and clusters of seizures in children. Full-Text PDF