Abstract Details

Title A Three Year Retrospective Chart Review of Patients in Convulsive Status Epilepticus Presenting to the Emergency Department

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P3 - Poster Session 3 (12:00 PM-1:00 PM)

Poster/Presentation
Number 12-010

Objective To evaluate adherence to our institution’s status epilepticus protocol in adult and pediatric patients entering the emergency department in convulsive status epilepticus.

Background Early identification and treatment of status epilepticus are closely tied to patient outcomes. Our institution has a specific hospital-approved protocol for acute management of these critically patients which was established and continues to be reviewed and updated regularly since 2010. This protocol outlines the current evidenced based recommendations in a treatment algorithm for management as well as specific timing of medications. Clinical observation suggests that this protocol is not uniformly applied in the emergency department setting which has the potential for treatment failure and adverse outcomes.

Design/Methods This study was a retrospective chart review of pediatric and adult patients from 2012-2014 who entered the emergency department with active and ongoing convulsive status epilepticus. Once patients were identified via a chart review screening process, data was collected regarding medication choice and administration time to evaluate practices that were aligned with the institutional status epilepticus protocol.

Results The total number of patients meeting inclusion criteria was 97. During this time period, the median time to administration of first medication was 14 minutes, time from first to second medication was 12 minutes and time from second to third medication was 12 minutes. 27% of patients were treated in a manner that was on target with the protocol. 39% were treated with a non-adherent sequence of medications, and 34% were treated with sequence of medications that followed the protocol, but not within the recommended time limits.

Conclusions Evaluating long term adherence to our institutional protocol for rapid treatment of status epilepticus helps provide objective data across a three year duration to identify specific areas for future interventions to improve the care of these critically ill patients.

Authors/Disclosures
Dana L. Vanino, DO (Geisinger Medical Center) PRESENTER	Dr. Vanino has nothing to disclose.
Trenton J. Tollefson, MD	Dr. Tollefson has nothing to disclose.
Inna Hughes, MD, PhD (University of Rochester Medical Center)	No disclosure on file
Lynn Liu, MD, FAAN (University of North Carolina - Chapel Hill)	Dr. Liu has nothing to disclose.

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