Effect of prehospital treatment on the outcome of status epilepticus in children

Alldredge, Brian K.; Pharm, D; Wall, Derek B.; Ferriero, Donna M.

doi:10.1016/0887-8994(95)00044-g

Cited by 148 publications

(135 citation statements)

References 9 publications

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“…Delays in time to treatment are independently associated with worse outcomes in the short term (higher mortality, higher need for continuous infusions, longer convulsive duration, and more frequent hypotension) 1, 2, 3, 33, 82, 83. Families and caregivers play a crucial role, as timely treatment is often possible if families and caregivers administer a rescue medication at home and quickly call emergency services 84, 85, 86. However, a survey of 100 families of patients with epilepsy showed that 87% had a rescue medication prescription, but only 61% of them reported receiving training on how to use it 86, 87.…”

Section: Factors Affecting Outcomementioning

confidence: 99%

“…Families and caregivers play a crucial role, as timely treatment is often possible if families and caregivers administer a rescue medication at home and quickly call emergency services 84, 85, 86. However, a survey of 100 families of patients with epilepsy showed that 87% had a rescue medication prescription, but only 61% of them reported receiving training on how to use it 86, 87. Furthermore, a study showed that only 37.5% of patients received prehospital treatment 85.…”

Section: Factors Affecting Outcomementioning

confidence: 99%

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Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

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SummaryWe reviewed 37 studies reporting long‐term outcomes after a status epilepticus (SE) episode in pediatric and adult populations. Study design, length of follow‐up, outcome measures, domains investigated (mortality, SE recurrence, subsequent epilepsy, cognitive outcome, functional outcome, or quality of life), and predictors of long‐term outcomes are summarized. Despite heterogeneity in the design of prior studies, overall risk of poor long‐term outcome after SE is high in both children and adults. Etiology is the main determinant of outcome, and the effect of age or SE duration is often difficult to distinguish from the underlying cause. The effect of the treatment on long‐term outcome after SE is still unknown.

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Section: Factors Affecting Outcomementioning

confidence: 99%

Section: Factors Affecting Outcomementioning

confidence: 99%

Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

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“…Alldredge et al suggested that prehospital administration of diazepam may shorten the duration of SE in children and simplify the subsequent management of these patients in the emergency department. 12 Prolonged duration of the seizure before arrival to ER had poor outcome (p <0.05). Gulati et al found that seizure duration more than 45 minutes is significantly associated with higher mortality.…”

Section: Discussionmentioning

confidence: 99%

Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

Thandavarayan

Ramaswamy

Bose

et al. 2017

Int J Contemp Pediatr

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Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children.

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“…70 A small prehospital study also demonstrated that mean doses of 0.2 mg/kg of IV diazepam resulted in more respiratory depression than a mean rectal dose of 0.6 mg/kg. 71 …”

Section: Recommendation #12mentioning

confidence: 99%

An Evidence-based Guideline for Pediatric Prehospital Seizure Management Using GRADE Methodology

Shah¹,

Macias²,

Dayan³

et al. 2013

Prehospital Emergency Care

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Objective. The objective of this guideline is to recommend evidence-based practices for timely prehospital pediatric seizure cessation while avoiding respiratory depression and seizure recurrence. Methods. A multidisciplinary panel was chosen based on expertise in pediatric emergency medicine, prehospital medicine, and/or evidence-based guideline development. The panel followed the National Prehospital EBG Model using the GRADE methodology to formulate questions, retrieve evidence, appraise the evidence, and formu- The panel finalized a draft of a patient care algorithm in 2012 that was presented to stakeholder organizations to gather feedback for necessary revisions. Results. Five strong and ten weak recommendations emerged from the process; all but one was supported by low or very low quality evidence. The panel sought to ensure that the recommendations promoted timely seizure cessation while avoiding respiratory depression and seizure recurrence. The panel recommended that all patients in an active seizure have capillary blood glucose checked and be treated with intravenous (IV) dextrose or intramuscular (IM) glucagon if <60 mg/dL (3 mmol/L). The panel also recommended that non-IV routes (buccal, IM, or intranasal) of benzodiazepines (0.2 mg/kg) be used as first-line therapy for status epilepticus, rather than the rectal route. Conclusions. Using GRADE methodology, we have developed a pediatric seizure guideline that emphasizes the role of capillary blood glucometry and the use of buccal, IM, or intranasal benzodiazepines over IV or rectal routes. Future research is needed to compare the effectiveness and safety of these medication routes.

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Effect of prehospital treatment on the outcome of status epilepticus in children

Cited by 148 publications

References 9 publications

Long‐term outcomes of status epilepticus: A critical assessment

Long‐term outcomes of status epilepticus: A critical assessment

Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

An Evidence-based Guideline for Pediatric Prehospital Seizure Management Using GRADE Methodology

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