Statewide Emergency Medical Services Protocols for Status Epilepticus Management.

Ethan J Han, Carlin C Chuck, Thomas J Martin, Tracy E Madsen, Jan Claassen, Michael E Reznik

Annals of neurology 2021 Mar

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Although seizures are common in prehospital settings, standardized emergency medical services (EMS) treatment algorithms do not exist nationally. We examined nationwide variability in status epilepticus treatment by analyzing 33 publicly available statewide EMS protocols. All adult protocols recommend intravenous benzodiazepines (midazolam, n = 33; lorazepam, n = 23; diazepam, n = 24), 30 recommend intramuscular benzodiazepines (midazolam, n = 30; lorazepam, n = 8; diazepam, n = 3), and 27 recommend intranasal benzodiazepines (midazolam, n = 27; lorazepam, n = 3); pediatric protocols also frequently recommend rectal diazepam (n = 14). Recommended dosages vary widely, and first- and second-line agents are designated in only 18 and 2 states, respectively. Given this degree of variability, standardized national EMS guidelines are needed. ANN NEUROL 2021;89:604-609. © 2020 American Neurological Association.

Citation

Ethan J Han, Carlin C Chuck, Thomas J Martin, Tracy E Madsen, Jan Claassen, Michael E Reznik. Statewide Emergency Medical Services Protocols for Status Epilepticus Management. Annals of neurology. 2021 Mar;89(3):604-609