Pre-hospital ambulance care of patients following a suspected seizure: A cross sectional study

Dickson, Jon M; Asghar, Zahid; Siriwardena, Aloysius Niroshan

doi:10.1016/j.seizure.2018.03.006

Cited by 21 publications

(17 citation statements)

References 17 publications

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“…The estimate is in line, however, with the findings of a current meta‐analysis of 0.34% to 0.76% in the Nordic countries . The number of EMS assignments for seizures is similar to that of a recent UK study (Gothenburg: 0.0023 assignments/inhabitant/year, East Midlands: 0.0021 assignments/inhabitant/year) …”

Section: Discussionsupporting

confidence: 82%

“…26 The number of EMS assignments for seizures is similar to that of a recent UK study (Gothenburg: 0.0023 assignments/inhabitant/year, East Midlands: 0.0021 assignments/inhabitant/year). 27 There are a number of limitations to our investigation. First of all, although reporting to the NPR is mandatory, misdiagnosis of epilepsy is not uncommon.…”

Section: Discussionmentioning

confidence: 95%

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High‐resolution mapping of epilepsy prevalence, ambulance use, and socioeconomic deprivation in an urban area of Sweden

Magnusson

Zelano

2019

Epilepsia

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Objective Geographic differences in epilepsy prevalence between areas of different socioeconomic standing have been demonstrated in the United Kingdom, but knowledge from other health care systems is scarce. Our objective was to compare epilepsy prevalence and emergency medical service (EMS) assignments for seizures in areas of different socioeconomic standings in the urban area of Gothenburg. Methods Register‐based study in Gothenburg (population 690 000), the second largest city in Sweden. Epilepsy cases were identified in the comprehensive national patient register in 2014‐2015. EMS assignments were identified in the EMS dispatch system in 2013‐2018. Socioeconomic variables were mean income and proportion of welfare recipients. Results Significant correlations were seen between epilepsy prevalence and the proportion of welfare recipients (r = .49, P = .0014) and annual income per capita (r = −.42, P = .0071). There were 7907 assignments for seizures during the study years. GPS‐based analysis showed that most assignments occurred in the city center. In addition, several high‐density areas correlated with areas with a high proportion of inhabitants receiving welfare. Correlation analysis showed significant associations between the number of EMS assignments per capita and the proportion of welfare recipients (r = .31, P < .0001) and income (r = −.19, P < .0001). When comparing representative areas, a greater proportion of assignments was given the highest priority in high status areas compared to low status areas, both by the dispatch center and EMS clinicians on scene. Significance Our findings that epilepsy prevalence and seizure frequency differ with socioeconomic status on a microgeographic level considerably strengthen the generalizability of previous observations across different health care systems. Differences in priority may reflect health utilization behavior or access to neurologic care.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 95%

High‐resolution mapping of epilepsy prevalence, ambulance use, and socioeconomic deprivation in an urban area of Sweden

Magnusson

Zelano

2019

Epilepsia

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“…1 ) [ 17 ]. This includes people who do not not seek emergency care in the first instance, and others declining a visit ED even after an ambulance has attended [ 27 , 28 ]. The aim of the current study was therefore to elicit PWE and carer experiences and preferences for emergency service care following a seizure.…”

Section: Introductionmentioning

confidence: 99%

Patient views on use of emergency and alternative care services for adult epilepsy: A qualitative study

McKinlay

Morgan

Noble

et al. 2020

Seizure

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Highlights We interviewed highly informed people with epilepsy and their carers Participants usually preferred to avoid emergency services after a typical seizure They developed strategies to manage themselves without emergency services Improved communication between existing services will facilitate appropriate care Two alternative pathways were not viewed as replacements for emergency care

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“…While missingness on core data items is anticipated to be low, 62 76 missingness on wider items might be higher since tests may not be performed if expected to be normal and not all PCR fields are mandatory. 77 78 Where data are ‘expectedly’ missing (ie, the test is not performed as not clinically indicated), an additional category of ‘not clinically indicated’ will be added to the variable.…”

Section: Methods and Analysismentioning

confidence: 99%

Supporting the ambulance service to safely convey fewer patients to hospital by developing a risk prediction tool: Risk of Adverse Outcomes after a Suspected Seizure (RADOSS)—protocol for the mixed-methods observational RADOSS project

et al. 2022

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IntroductionAmbulances services are asked to further reduce avoidable conveyances to emergency departments (EDs). Risk of Adverse Outcomes after a Suspected Seizure seeks to support this by: (1) clarifying the risks of conveyance and non-conveyance, and (2) developing a risk prediction tool for clinicians to use ‘on scene’ to estimate the benefits an individual would receive if conveyed to ED and risks if not.Methods and analysisMixed-methods, multi-work package (WP) project. For WP1 and WP2 we shall use an existing linked data set that tracks urgent and emergency care (UEC) use of persons served by one English regional ambulance service. Risk tools are specific to clinical scenarios. We shall use suspected seizures in adults as an exemplar.WP1: Form a cohort of patients cared for a seizure by the service during 2019/2020. It, and nested Knowledge Exchange workshops with clinicians and service users, will allow us to: determine the proportions following conveyance and non-conveyance that die and/or recontact UEC system within 3 (/30) days; quantify the proportion of conveyed incidents resulting in ‘avoidable ED attendances’ (AA); optimise risk tool development; and develop statistical models that, using information available ‘on scene’, predict the risk of death/recontact with the UEC system within 3 (/30) days and the likelihood of an attendance at ED resulting in an AA.WP2: Form a cohort of patients cared for a seizure during 2021/2022 to ‘temporally’ validate the WP1 predictive models.WP3: Complete the ‘next steps’ workshops with stakeholders. Using nominal group techniques, finalise plans to develop the risk tool for clinical use and its evaluation.Ethics and disseminationWP1a and WP2 will be conducted under database ethical approval (IRAS 307353) and Confidentiality Advisory Group (22/CAG/0019) approval. WP1b and WP3 have approval from the University of Liverpool Central Research Ethics Committee (11450). We shall engage in proactive dissemination and knowledge mobilisation to share findings with stakeholders and maximise evidence usage.

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Pre-hospital ambulance care of patients following a suspected seizure: A cross sectional study

Cited by 21 publications

References 17 publications

High‐resolution mapping of epilepsy prevalence, ambulance use, and socioeconomic deprivation in an urban area of Sweden

High‐resolution mapping of epilepsy prevalence, ambulance use, and socioeconomic deprivation in an urban area of Sweden

Patient views on use of emergency and alternative care services for adult epilepsy: A qualitative study

Supporting the ambulance service to safely convey fewer patients to hospital by developing a risk prediction tool: Risk of Adverse Outcomes after a Suspected Seizure (RADOSS)—protocol for the mixed-methods observational RADOSS project

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