Seizure Treatment in Children Transported to Tertiary Care: Recommendation Adherence and Outcomes

Convulsive seizures account for 15% of pediatric air transports. We evaluated seizure treatment received in community hospital emergency departments among transported patients for adherence to recommended management. This study was a retrospective cohort study of children transported for an acute se...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2016-12, Vol.138 (6), p.1
Main Authors: Siefkes, Heather M, Holsti, Maija, Morita, Denise, Cook, Lawrence J, Bratton, Susan
Format: Article
Language:English
Subjects:
Analysis
Anticonvulsants - therapeutic use
Child
Child, Preschool
Children
Clinical outcomes
Cohort Studies
Convulsions & seizures
Dosage and administration
Drug dosages
Emergency medical care
Emergency Medical Services
Evidence-based medicine
Female
Guideline Adherence - statistics & numerical data
Health aspects
Humans
Infant
Intubation
Intubation, Intratracheal - statistics & numerical data
Male
Outcome and process assessment (Health Care)
Outcome and process assessment (Medical care)
Patient compliance
Pediatrics
Retrospective Studies
Seizures (Medicine)
Seizures - therapy
Tertiary Healthcare
Transportation of Patients
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Summary:Convulsive seizures account for 15% of pediatric air transports. We evaluated seizure treatment received in community hospital emergency departments among transported patients for adherence to recommended management. This study was a retrospective cohort study of children transported for an acute seizure to a tertiary pediatric hospital from 2010 to 2013. Seizure treatment was evaluated for adherence to recommended management. The primary outcome was intubation. Among 126 events, 61% did not receive recommended acute treatment. The most common deviation from recommended care was administration of >2 benzodiazepine doses. Lack of adherence to recommended care was associated with a greater than twofold increased risk of intubation (relative risk 2.4; 95% confidence interval, 1.4-4.13) and 1.5-fold increased risk of admission to the ICU (relative risk 1.65; 95% confidence interval, 1.24-2.16). Duration of ventilation was commonly
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2016-1527