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Neurocritical Care

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01-08-2013 | Original Article

Analysis of the Delay Components in the Treatment of Status Epilepticus

Authors: Leena Kämppi, Harri Mustonen, Seppo Soinila

Published in: Neurocritical Care | Issue 1/2013

Abstract

Background

The factors comprising the delays in management of status epilepticus (SE) have not been systematically studied.

Methods

We studied retrospectively all adult patients (N = 82) diagnosed with SE in Helsinki University Central Hospital emergency room over a 2-year period. We analyzed prehospital, diagnostic, treatment, and treatment response delays based on medical records and quantitatively evaluated data availability and accuracy.

Results

SE manifested mostly without any warning symptoms, but every fifth case presented a pre-status period. Median prehospital delay was 2 h 4 min, including delays in emergency call, ambulance arrival, and patient transportation. Median delay of diagnosing SE was 2 h 10 min. EEG-based diagnosis was significantly delayed compared to clinical diagnosis. Median delay in recording EEG was 22 h 2 min. Median delay of the first medication was 35 min, and those of second- and third-stage medications were 3 h and 2 h 55 min, respectively. We applied stepwise definition for treatment response and counted delays accordingly: total convulsion period 5 h 52 min, Burst-suppression (BS) 17 h 30 min and return of consciousness 47 h 40 min. Median treatment period in intensive care unit was 2.7 days. Mortality over treatment period (median 7.7 days) was 8.5 %. No post-discharge follow-up was performed.

Conclusion

Our study reveals unexpectedly and unacceptably long delays in SE management, stressing the importance of commitment to acknowledged management protocol. Delays in the treatment can and need to be shortened markedly by several strategies discussed in this article.

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Title: Analysis of the Delay Components in the Treatment of Status Epilepticus
Authors: Leena Kämppi
Harri Mustonen
Seppo Soinila
Publication date: 01-08-2013
Publisher: Springer US
Published in: Neurocritical Care / Issue 1/2013
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-013-9862-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Analysis of the Delay Components in the Treatment of Status Epilepticus

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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