An alternative care pathway for suspected seizures in pre-hospital care: a service evaluation

Abstract

Introduction -An uncomplicated, self-limiting epileptic seizure in a patient with an established diagnosis of epilepsy usually requires only first aid, but in the UK it is estimated that 75% of these patients are transported to hospital and many are discharged without review or follow-up with an epilepsy specialist. Alternative care pathways have the potential to reduce unnecessary conveyance to hospital and to improve rates of epilepsy specialist follow-up, and thereby increase the quality and cost effectiveness of care.Methods -A service evaluation of a new alternative care pathway in a regional ambulance service in the UK. The alternative care pathway allowed paramedics to refer eligible patients to an epilepsy specialist nurse service.

Exploring epilepsy attendance at the emergency department and interventions which may reduce unnecessary attendances: A scoping review

“…Despite this being a small study it was able to give a snapshot.. These results further demonstrate the potential for improved and more cost-effective emergency management of suspected seizures [32].…”

“…Three of the included reports assessed the role of ambulance staff, within the UK, in managing seizures were qualitative [28][29][30] with two further quantitative reports [31,32]. Whilst two of the studies included staff across five NHS organizations, the total number of participants for each was small.…”

“…But, the data collected is informative enough to highlight the size of the problem, answer our aims and provide evidence based insights on how to help overcome it. Further the review process by experts helped identify notable exceptions which were included within the evidence [31,32]. It is recognised that there may be information available within unpublished data designed to reduce attendances at ED.…”

Developing patient-centred, feasible alternative care for adult emergency department users with epilepsy: protocol for the mixed-methods observational ‘Collaborate’ project

“…It will bring patients/carers from the target population, healthcare professionals and commissioners together to identify which ACP configuration best encapsulates the features important to patients and carers and is feasible within the NHS context. The focus will be on the care of adults with epilepsy, rather than children/young people, since discussion to date relating to the use of ACPs and ED care has largely focused on the former (eg, 19 62…”

“…To date, only one epilepsy ACP has been reported on 62. Despite the evaluation revealing positive outcomes, less than 10% of eligible PWE attended to by paramedics were put onto the ACP.…”