- •Time to treatment of pediatric status epilepticus remains delayed.
- •Multiple barriers to timely management exist in the pre- and in-hospital settings.
- •Proposed interventions to improve time to treatment are reviewed.
- •Status epilepticus should be recognized as a time-sensitive emergency.
- •Acute intervention teams can be developed to improve status epilepticus management.
Abbreviations:ASM (antiseizure medication), ED (emergency department), EMS (emergency medical services), GABA (gamma-aminobutyric acid), IV (intravenous), OR (odds ratio), RR (relative risk), SE (status epilepticus)
2. Evidence guiding ASM choice and administration
- Dalziel S.R.
- Furyk J.
- Bonisch M.
- Oakley E.
- Borland M.
- Neutze J.
- et al.
- Lyttle M.D.
- Gamble C.
- Messahel S.
- Hickey H.
- Iyer A.
- Woolfall K.
- et al.
3. Time to treatment recommendations & outcomes associated with delays
4. Barriers to timely management and methods of improving time to treatment
|Area of Delay||Proposed Interventions|
|Lack of Preventive Care|
|Seizure Detection by Caregivers/Patients|
|Rescue Medication Use by Caregivers and Schools|
|Summoning and Arrival of Emergency Personnel|
|Medication Use by Pre-Hospital Emergency Personnel|
|Use of Inappropriately Dosed Medications Pre- and In-Hospital|
|In-Hospital ASM Use|
4.1 Missed clinic visits and lack of preventive care and education
4.2 Seizure detection by caregivers/patients
4.3 Rescue medication use by caregivers and schools
4.4 Summoning and arrival of emergency personnel
4.5 Medication use by pre-hospital emergency personnel
4.6 Use of inappropriately dosed medications pre- and in-hospital
4.7 In-hospital ASM use
Conflicts of interest/disclosures
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