Pediatric status epilepticus management by Emergency Medical Services (the pSERG cohort)

Delayed treatment in status epilepticus (SE) is independently associated with increased treatment resistance, morbidity, and mortality. We describe the prehospital management pathway and Emergency Medical Services (EMS) timeliness in children who developed refractory convulsive status epilepticus (R...

Full description

Saved in:
Bibliographic Details
Published in:Seizure (London, England) England), 2023-10, Vol.111, p.51-55
Main Authors: Amengual-Gual, Marta, Sánchez Fernández, Iván, Vasquez, Alejandra, Abend, Nicholas S., Anderson, Anne, Arya, Ravindra, Barcia Aguilar, Cristina, Brenton, J. Nicholas, Carpenter, Jessica L., Chapman, Kevin E., Clark, Justice, Farias-Moeller, Raquel, Gaillard, William D., Glauser, Tracy A., Goldstein, Joshua L., Goodkin, Howard P., Lai, Yi-Chen, Mikati, Mohamad A., Morgan, Lindsey A., Novotny, Edward J., Ostendorf, Adam P., Payne, Eric T., Peariso, Katrina, Piantino, Juan, Reece, Latania, Riviello, James J., Sannagowdara, Kumar, Sheehan, Theodore, Tasker, Robert C., Tchapyjnikov, Dmitry, Topjian, Alexis A., Wainwright, Mark S., Wilfong, Angus, Williams, Korwyn, Loddenkemper, Tobias
Format: Article
Language:English
Subjects:
Emergency Medical Services (EMS)
Epilepsy
Guidelines
Prehospital management
Status epilepticus
Treatment
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Delayed treatment in status epilepticus (SE) is independently associated with increased treatment resistance, morbidity, and mortality. We describe the prehospital management pathway and Emergency Medical Services (EMS) timeliness in children who developed refractory convulsive status epilepticus (RCSE). Retrospective multicenter study in the United States using prospectively collected observational data from June 2011 to March 2020. We selected pediatric patients (one month–21 years) with RCSE initiated outside the hospital and transported to the hospital by EMS. We included 91 patients with a median (percentile25-percentile75) age of 3.0 (1.5–7.3) years. The median time from seizure onset to hospital arrival was 45 (30–67) minutes, with a median time cared for by EMS of 24 (15–36) minutes. Considering treatment by caregivers and EMS before hospital arrival, 20 (22%) patients did not receive any anti-seizure medications (ASM) and 71 (78%) received one to five doses of benzodiazepines (BZD), without non-BZD ASM. We provided the prehospital treatment flow path of these patients through caregivers and EMS including relevant time points. Patients with a history of SE were more likely to receive the first BZD in the prehospital setting compared to patients without a history of SE (adjusted HR 3.25, 95% CI 1.72–6.12, p
ISSN:1059-1311
1532-2688
DOI:10.1016/j.seizure.2023.07.010