Variation in Prehospital Protocols for Pediatric Seizure Within the United States
| العنوان: | Variation in Prehospital Protocols for Pediatric Seizure Within the United States |
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| المؤلفون: | Sylvia Owusu-Ansah, Sriram Ramgopal, Kerry McCans, Christian Martin-Gill |
| المصدر: | Pediatric Emergency Care. 37:e1331-e1338 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Emergency Medical Services, medicine.medical_specialty, Midazolam, MEDLINE, Benzodiazepines, 03 medical and health sciences, 0302 clinical medicine, Seizures, 030225 pediatrics, Febrile seizure, Emergency medical services, medicine, Humans, Antipyretic, Dosing, Child, Protocol (science), business.industry, Drug dosages, 030208 emergency & critical care medicine, General Medicine, medicine.disease, United States, Pediatrics, Perinatology and Child Health, Emergency medicine, Emergency Medicine, Anticonvulsants, business, medicine.drug |
| الوصف: | Objective The objective of this study was to compare statewide prehospital protocols for the management of pediatric seizures. Methods We performed a descriptive analysis comparing statewide protocols for emergency medical services management of pediatric seizures within the United States, excluding states for which no statewide protocol/model was available. We compared antiepileptic drugs (AEDs), routes and doses of administration, and differences in febrile seizure management. Results Of 50 states, 34 had either statewide protocols or models and were included. All had a protocol for the management of seizures and provided specific recommendations for the management of pediatric seizures. Twelve states (35%) preferentially recommended midazolam over other benzodiazepines. Thirty-two (94%) of 34 allowed for use of midazolam, with variable use of other AEDs. All allowed for use of intramuscular AED. Twenty-six (77%) allowed for intranasal AED. Nine (27%) allowed emergency medical services to administer a patient's own abortive AED, and 6 (18%) allowed for use of a patient's vagal nerve stimulator, when present. There was a wide variability with respect to dosing ranges for medications. Thirty-two (94%) of 34 included blood glucose measurement within the protocol. Twenty-one protocols (62%) provided recommendations for febrile seizures, including recommending active/passive cooling (8/34, 24%) and antipyretic administration (9/34, 26%). Conclusions All statewide protocols carried specific guidelines for the prehospital management of pediatric seizures; however, there was wide variability with respect to specific AEDs, routes of administration, and drug dosages. In addition to broader availability of statewide guidance, areas of potential protocol improvement and research include AED dose optimization, reprioritization of blood glucose, and greater emphasis on intranasal or intramuscular medication dosing. |
| تدمد: | 1535-1815 0749-5161 |
| DOI: | 10.1097/pec.0000000000002029 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::eb77742c4264c9623b92414a3a540f4c https://doi.org/10.1097/pec.0000000000002029 |
| رقم الانضمام: | edsair.doi.dedup.....eb77742c4264c9623b92414a3a540f4c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15351815 07495161 |
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| DOI: | 10.1097/pec.0000000000002029 |