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Abstract Details

Assessment of Practice Patterns and Provider Confidence in Management of Status Epilepticus in the Emergency Department
Epilepsy/Clinical Neurophysiology (EEG)
P6 - Poster Session 6 (11:45 AM-12:45 PM)
9-014
To assess the current state of practice habits and confidence of healthcare personnel in managing status epilepticus (SE) in the Emergency Department (ED) at a regional academic medical center.
SE is a neurological emergency that warrants timely and effective therapy to reduce the risk for morbidity and mortality. Despite consensus practice guidelines, approaches to SE remain heterogeneous, with inefficient treatment and insufficient dosing of anti-seizure medications (ASMs) remaining prevalent.
This project was part of an interprofessional, and multidisciplinary quality improvement (QI) initiative to improve SE management in the ED. To assess the baseline practice patterns, an Electronic Medical Record data exploration tool was used to identify adult patients treated for convulsive SE in the ED in 2022-2024. Post-cardiac arrest patients and those determined to have non-epileptic events were excluded. An anonymous survey was conducted to gauge the level of confidence in SE management amongst ED personnel.

We identified 30 patients treated for clinically apparent SE, 20 of whom received insufficient doses of ASM therapy. In 2 of the 10 patients who did receive adequate doses, significant delays in administration occurred. 

The anonymous survey was completed by 36 individuals, comprised of registered nurses (47.2%), physicians (30.6%), pharmacists (19.4%), and advanced practice providers (2.8%). Four knowledge-based questions were presented, with a mean correct response rate of 62.5 %. Only 61% of the responders felt comfortable with the maximum recommended dose of intravenous lorazepam. Furthermore, only 1/17 nurses and 4/11 physicians were comfortable administering the maximum recommended dose of levetiracetam.
Our assessment of the current state of practice amongst those on the front line for SE management calls for the need to implement standardized practice guidelines, combined with interprofessional education programs and workflow improvement. This data serves as a crucial element that will drive our QI effort.
Authors/Disclosures
Alicia E. Dupre, MD (Oregon Health and Science University)
PRESENTER 		Dr. Dupre has nothing to disclose.
Manuel M. Gonzalez Gonzalez, MD, MBA Dr. Gonzalez Gonzalez has nothing to disclose.
Alexa Lyon, MD (OHSU) Dr. Lyon has nothing to disclose.
Christopher S. Zimmerman, DO (OHSU) Dr. Zimmerman has nothing to disclose.
Julia Durrant, MD (OHSU) Dr. Durrant has nothing to disclose.
Haley Manella, MD Dr. Manella has nothing to disclose.
Katherine Park, MD (Oregon Health Sciences University) Dr. Park has nothing to disclose.