Commentary on ‘Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children’, with a response from the review authors

McGillivray, David; Dayan, Peter; Pusic, Martin; Appleton, Richard; MacLeod, S. M.; Martland, Timothy

doi:10.1002/ebch.436

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…A standardized and simple seizure protocol is useful for preventing delays in treatment, avoiding medication errors, facilitating staff education, and promoting uniformity across management teams. 33 Our results are comparable to those previously achieved in three midazolam-based protocol studies in children with SE treated in a non-ED setting. The range of success in these studies was between 89 and 95%.…”

Section: Discussionsupporting

confidence: 87%

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Tourigny-Ruel

Diksic

Mok

et al. 2014

CJEM

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Objective: To evaluate the efficacy and safety of a simple linear midazolam-based protocol for the management of impending status epilepticus in children up to 18 years of age. Methods: This is a descriptive, quality assessment, retrospective chart review of children presenting with the chief complaint of seizure disorder in the emergency department (ED) of a tertiary care pediatric hospital and a triage category of resuscitation or urgent from April 1, 2009, to August 31, 2011 In children with at least one seizure episode in the ED treated according to the linear protocol, three main outcomes were assessed: compliance, effectiveness, and complications. Results: Of the 128 children meeting the above study criteria, 68 had at least one seizure episode in the ED, and treatment was required to terminate at least one seizure episode in 46 of 68 patients (67.6%). Fifty-five seizure episodes were treated in the 46 patients: 51 of 55 seizure episodes were treated with midazolam (92.7%) and 4 of 55 with lorazepam or diazepam (7.3%). Of those treated with midazolam, 86.3% (44 of 51) were successfully treated with one or two doses of midazolam. The median seizure duration for all treated patients was 6 minutes. Of the 42 patients treated with midazolam, 7 required either continuous positive airway pressure or intubation, and two patients were treated for hypotension. One patient died of pneumococcal meningitis. Conclusion: This simple linear protocol is an effective and safe regimen for the treatment of impending status epilepticus in children. RÉ SUMÉObjectif: L'é tude visait à é valuer l'efficacité et l'innocuité d'un simple protocole liné aire, fondé sur le midazolam, pour le traitement d'un é tat de mal é pileptique imminent, chez des enfants â gé s de 18 ans et moins.

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Section: Discussionsupporting

confidence: 87%

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Tourigny-Ruel

Diksic

Mok

et al. 2014

CJEM

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“…Various medicines as lorazepam (0.5 to 0.1mg/kg IV), diazepam (0.1-0.3mg/kg IV, 0.5mg/kg PR) and midazolam (buccal, intranasal, intramuscular) are used effectively as first line agents. [5][6][7][8] In all above, commonly used benzodiazepines diazepam and it can be administered intravenously as well as per rectal, but for administration of diazepam for control of acute seizures in emergency, intravenous cannulation has to be done and it is a major barrier for rapid and effective management. 9 In a study Shresti presented that mean time taken for administration of drug was much less in intramuscular midazolam group (0.17±0.046 minutes) as compared intravenous diazepam (4.19±1.15) (p<0.001).…”

Section: Introductionmentioning

confidence: 99%

Outcome of Intramuscular Midazolam Versus Intravenous Diazepam for Control of Acute Seizures

Khawa¹,

Liaqat²,

Sherazi³

2018

Pak Postgrad Med J.

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Objective: To compare midazolam and diazepam given via intramuscular and intravenous route respectively for management of fits in children presenting in emergency. Study Design: Randomized controlled study Place and Duration: This study was conducted in Paediatrics Emergency, Ittefaq Trust Hospital, Lahore from 24th June 2013 to 23rd December 2013. Materials and Methods: In this study we took 60 cases and assigned them group A and B (30 cases in each group). Group A was given 0.2mg/kg/dose midazolam via intramuscular route and group B was given intravenous diazepam (0.2mg/kg/dose)for management of fits. Results: Mean age was 2.59±2.88 and 3.55±3.09 years in group A and B respectively. Group A and B included 17 (56.7%) &18 (60%) males respectively while there were 13 (43.3%) and 12 (40%) females in group-A and B respectively. It was observed that in Group A (I/M midazolam) time interval was significantly less as compared to Group-B (I/v diazepam) (5.89±2.63 vs 8.35±2.88 minute) p<0.001 for control of seizure (minutes). Conclusion: Intramuscular midazolam is effective in controlling acute seizures significantly as compared to intravenous diazepam.

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Commentary on ‘Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children’, with a response from the review authors

Cited by 2 publications

References 18 publications

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Outcome of Intramuscular Midazolam Versus Intravenous Diazepam for Control of Acute Seizures

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