TY - JOUR
T1 - Pediatric status epilepticus management by Emergency Medical Services (the pSERG cohort)
AU - Pediatric Status Epilepticus Research Group (pSERG)
AU - Amengual-Gual, Marta
AU - Sánchez Fernández, Iván
AU - Vasquez, Alejandra
AU - Abend, Nicholas S.
AU - Anderson, Anne
AU - Arya, Ravindra
AU - Barcia Aguilar, Cristina
AU - Brenton, J. Nicholas
AU - Carpenter, Jessica L.
AU - Chapman, Kevin E.
AU - Clark, Justice
AU - Farias-Moeller, Raquel
AU - Gaillard, William D.
AU - Glauser, Tracy A.
AU - Goldstein, Joshua L.
AU - Goodkin, Howard P.
AU - Lai, Yi Chen
AU - Mikati, Mohamad A.
AU - Morgan, Lindsey A.
AU - Novotny, Edward J.
AU - Ostendorf, Adam P.
AU - Payne, Eric T.
AU - Peariso, Katrina
AU - Piantino, Juan
AU - Reece, Latania
AU - Riviello, James J.
AU - Sannagowdara, Kumar
AU - Sheehan, Theodore
AU - Tasker, Robert C.
AU - Tchapyjnikov, Dmitry
AU - Topjian, Alexis A.
AU - Wainwright, Mark S.
AU - Wilfong, Angus
AU - Williams, Korwyn
AU - Loddenkemper, Tobias
N1 - Publisher Copyright:
© 2023
PY - 2023/10
Y1 - 2023/10
N2 - 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). Methods: 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. Patients with a history of SE were more likely to receive prehospital rescue medication.
AB - 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). Methods: 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. Patients with a history of SE were more likely to receive prehospital rescue medication.
KW - Emergency Medical Services (EMS)
KW - Epilepsy
KW - Guidelines
KW - Prehospital management
KW - Status epilepticus
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85166124943&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85166124943&partnerID=8YFLogxK
U2 - 10.1016/j.seizure.2023.07.010
DO - 10.1016/j.seizure.2023.07.010
M3 - Article
C2 - 37523933
AN - SCOPUS:85166124943
SN - 1059-1311
VL - 111
SP - 51
EP - 55
JO - Seizure
JF - Seizure
ER -