The need for improved management of status epilepticus in children in Australia: Time from seizure onset to treatment is consistently delayed.
J Paediatr Child Health
; 58(2): 261-266, 2022 Feb.
Article
en En
| MEDLINE
| ID: mdl-34397128
ABSTRACT
AIM:
To determine if the management of paediatric status epilepticus (SE) follows accepted clinical practice guidelines.METHODS:
Retrospective, consecutive series of patients with SE who attended the emergency departments from two NSW sites over a 12-month period. SE was defined as a convulsive seizure, 5 min or more in duration. Time to presentation to the ED, time to first- and second-line treatment, number of benzodiazepine (BZD) doses given prior to intubation and adherence to guidelines were evaluated. The outcomes included seizure duration, need for respiratory support, admission to intensive care, morbidity and mortality.RESULTS:
The time from onset of seizure to ED presentation was a median (p25-p75) time of 22 (15-40) min. Forty-eight of 59 presentations received pre-hospital midazolam. The median (p25-p75) time to first-line treatment was 15 (8-25) min and to second-line treatment was 43.5 (35-59) min. There was no significant difference in the results in the two hospitals. The total number of BZD doses ranged from 1 to 7 (median 3). There was non-adherence to the clinical practice guidelines in 55 (93.2%) of 59 presentations.CONCLUSIONS:
We found excessive benzodiazepine use and delay in both definitive treatment of status epilepticus and in escalation from first- to second-line anticonvulsant treatment. This raises the need for rapid escalation of treatment. We propose a 'status epilepticus code' for emergency departments.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Estado Epiléptico
Tipo de estudio:
Guideline
/
Observational_studies
Límite:
Child
/
Humans
País/Región como asunto:
Oceania
Idioma:
En
Revista:
J Paediatr Child Health
Asunto de la revista:
PEDIATRIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Australia