Emergency Department Management of Pediatric Unprovoked Seizures and Status Epilepticus in the State of Illinois

Abstract

The purpose of this survey and record review was to characterize emergency department management of unprovoked seizures and status epilepticus in children in Illinois. The survey was sent to 119 participating emergency departments in the Emergency Medical Services for Children program; responses were received from 103 (88% response rate). Only 44% of the emergency departments had a documented protocol for seizure management. Only 12% of emergency departments had child neurology consultation available at all times. Record review showed that 58% of patients were discharged home, 26% were transferred to another institution, and 10% were admitted to a non-intensive care unit setting. Ninety percent of patients were treated with anticonvulsants. Seizure education was provided by the primary emergency department nurse (97%) and the treating physician (79%). This project demonstrated strengths and weaknesses in the current management of pediatric seizure patients in Illinois emergency departments.

Descriptive epidemiology and health resource utilization for status epilepticus in the emergency department in the United States of America

“…The current study addresses several gaps in prior literature: 1) It estimates for the first time the proportion of cases with SE presenting to the ED admitted to the hospital: approximately 70% of cases with primary SE and approximately 85% of cases with secondary SE. Although there is no prior literature to compare these results, the proportion of cases admitted to the hospital when presenting to the ED for non-SE seizures (approximately 15% in our study), is very similar to the estimations in prior literature (15-25%) [1,10,11], validating our approach.…”

“…Although we focused on the USA literature in this manuscript, some of the findings are roughly applicable to most developed countries, although the healthcare spending in the USA is approximately twice that of other developed countries [9]. Approximately 15-25% of patients presenting with seizures to the ED get admitted to the hospital [1,10,11], but there are no data on the proportion of patients presenting with SE to the ED who get admitted to the hospital. Similarly, although there is some literature on the proportion of patients with seizures transferred from the ED to another hospital [10], there are no data on the proportion of patients with SE who get transferred from the ED to another hospital.…”

Uncommon Infectious Disease Presentations and a Reminder that Quality Improvement Is Meant to Improve Care

“…[1][2][3] QI is meant to be a quantifiable measure of clinical care growth for patients and their families. When I was asked more than 30 years ago to set up our first QI departmental committee at Evanston Hospital in the Department of Pediatrics (Evanston, IL), we identified problem areas (needs analysis), shaped a dedicated multidisciplinary committee to discuss the problem, devised methods to intervene, studied the results of the intervention, and then worked to further improve the Plan Do Study Act cycle.…”