Pediatric status epilepticus management by Emergency Medical Services (the pSERG cohort)

被引：4

作者：

Amengual-Gual, Marta ^{[1
,2
]}

Fernandez, Ivan Sanchez ^{[1
,3
]}

Vasquez, Alejandra ^{[1
,4
]}

Abend, Nicholas S. ^{[5
]}

Anderson, Anne ^{[6
]}

Arya, Ravindra ^{[7
]}

Aguilar, Cristina Barcia ^{[1
,8
]}

Brenton, J. Nicholas ^{[9
]}

Carpenter, Jessica L. ^{[10
]}

Chapman, Kevin E. ^{[11
,12
,13
,14
]}

Clark, Justice ^{[1
]}

Farias-Moeller, Raquel ^{[15
]}

Gaillard, William D. ^{[10
]}

Glauser, Tracy A. ^{[7
]}

Goldstein, Joshua L. ^{[16
]}

Goodkin, Howard P.

Lai, Yi-Chen ^{[17
]}

Mikati, Mohamad A. ^{[18
]}

Morgan, Lindsey A. ^{[19
,20
]}

Novotny, Edward J. ^{[19
,20
]}

Ostendorfr, Adam P. ^{[21
]}

Payne, Eric T. ^{[22
]}

Peariso, Katrina ^{[7
]}

Piantino, Juan ^{[23
]}

Reece, Latania ^{[1
]}

Riviello, James J. ^{[6
]}

Sannagowdara, Kumar ^{[15
]}

Sheehan, Theodore ^{[1
]}

Tasker, Robert C. ^{[24
,25
,26
,27
]}

Tchapyjnikov, Dmitry ^{[18
]}

Topjianv, Alexis A. ^{[28
,29
]}

Wainwright, Mark S. ^{[19
,20
]}

Wilfong, Angus ^{[13
,14
]}

Williams, Korwyn

Loddenkemper, Tobias ^{[1
]}

机构：

[1] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA 02115 USA

[2] Univ Illes Balears, Palma De Mallorca, Spain

[3] Univ Barcelona, Hosp St Joan de Deu, Dept Child Neurol, Barcelona, Spain

[4] Mayo Clin, Dept Neurol, Div Child & Adolescent Neurol, Rochester, MN USA

[5] Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Div Neurol, Philadelphia, PA USA

[6] Baylor Coll Med, Dept Pediat, Sect Neurol & Dev Neurosci, Houston, TX USA

[7] Univ Cincinnati, Coll Med, Dept Pediat, Div Neurol,Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA

[8] Univ Autonoma Madrid, Hosp Univ La Paz, Dept Child Neurol, Madrid, Spain

[9] Univ Virginia Hlth Syst, Dept Neurol & Pediat, Charlottesville, VA USA

[10] George Washington Univ, Ctr Neurosci, Childrens Natl Med Ctr, Sch Med & Hlth Sci, Washington, DC USA

[11] Univ Colorado, Childrens Hosp Colorado, Dept Pediat Neurol, Sch Med, Aurora, CO USA

[12] Univ Colorado, Childrens Hosp Colorado, Dept Neurol, Sch Med, Aurora, CO USA

[13] Univ Arizona, Coll Med, Dept Pediat, Phoenix, AZ USA

[14] Phoenix Childrens Hosp, Barrow Neurol Inst, Phoenix, AZ USA

[15] Med Coll Wisconsin, Childrens Hosp Wisconsin, Div Pediat Neurol, Dept Neurol, Milwaukee, WI USA

[16] Northwestern Univ, Ruth D & Ken M Davee Pediat Neurocrit Care Progra, Feinberg Sch Med, Chicago, IL USA

[17] Baylor Coll Med, Dept Pediat, Div Pediat Crit Med, Houston, TX USA

[18] Duke Univ, Duke Univ Med Ctr, Div Pediat Neurol, Durham, NC USA

[19] Univ Washington, Seattle Childrens Hosp, Dept Neurol & Pediat, Div Pediat Neurol, Seattle, WA USA

[20] Univ Washington, Seattle Childrens Hosp, Dept Pediat, Div Pediat Neurol, Seattle, WA USA

[21] Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat, Columbus, OH USA

[22] Alberta Childrens Prov Gen Hosp, Dept Pediat, Div Neurol, Calgary, AB, Canada

[23] Oregon Hlth & Sci Univ, Dept Pediat, Div Pediat Neurol, Neurocrit Care Program, Portland, OR USA

[24] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Crit Care, Boston, MA USA

[25] Boston Childrens Hosp, Harvard Med Sch, Dept Anesthesiol, Div Crit Care, Boston, MA USA

[26] Boston Childrens Hosp, Harvard Med Sch, Dept Perioperat, Div Crit Care, Boston, MA USA

[27] Boston Childrens Hosp, Harvard Med Sch, Dept Pain Med, Div Crit Care, Boston, MA USA

[28] Univ Penn, Childrens Hosp Philadelphia, Dept Anesthesia & Crit care Med, Perelman Sch Med, Philadelphia, PA USA

[29] Univ Penn, Childrens Hosp Philadelphia, Dept Pediat, Perelman Sch Med, Philadelphia, PA USA

来源：

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2023年 / 111卷

关键词：

Status epilepticus; Epilepsy; Prehospital management; Emergency Medical Services (EMS); Treatment; Guidelines; CONVULSIVE STATUS EPILEPTICUS;

D O I：

10.1016/j.seizure.2023.07.010

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose: Delayed treatment in status epilepticus (SE) is independently associated with resistance, morbidity, and mortality. We describe the prehospital management pathway Services (EMS) timeliness in children who developed refractory convulsive status epilepticusMethods: Retrospective multicenter study in the United States using prospectively collected observational data from June 2011 to March 2020. We selected pediatric patients (one month-21 years) with RCSE initiated outside the hospital and transported to the hospital by EMS. Results: We included 91 patients with a median (percentile25-percentile75) age of 3.0 (1.5-7.3) years. The median time from seizure onset to hospital arrival was 45 (30-67) minutes, with a median time cared for by EMS of 24 (15-36) minutes. Considering treatment by caregivers and EMS before hospital arrival, 20 (22%) patients did not receive any anti-seizure medications (ASM) and 71 (78%) received one to five doses of benzodiazepines (BZD), without non-BZD ASM. We provided the prehospital treatment flow path of these patients through caregivers and EMS including relevant time points. Patients with a history of SE were more likely to receive the first BZD in the prehospital setting compared to patients without a history of SE (adjusted HR 3.25, 95% CI 1.72-6.12, p<0.001). Conclusion: In this multicenter study of pediatric RCSE, prehospital treatment may be streamlined further. Pa-tients with a history of SE were more likely to receive prehospital rescue medication.Purpose: Delayed treatment in status epilepticus (SE) is independently associated with increased treatment resistance, morbidity, and mortality. We describe the prehospital management pathway and Emergency Medical Services (EMS) timeliness in children who developed refractory convulsive status epilepticus (RCSE).

引用

页码：51 / 55

页数：5

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