Deviations From Recommended Care in Pediatric Seizure
Lack of adherence has been linked to increased risks of intubation and ICU admission.
HealthDay News -- For pediatric patients transported for an acute seizure, adherence to recommended treatment is poor, according to a study published in Pediatrics.
Heather M. Siefkes, MD, from the University of Utah in Salt Lake City, and colleagues conducted a retrospective cohort study of children transported to a tertiary pediatric hospital for an acute seizure from 2010 to 2013. The authors evaluated seizure treatment for adherence to recommended management.
The researchers found that 61% of the 126 events did not receive recommended acute treatment. Administration of more than 2 benzodiazepine doses was the most common deviation from recommended care. Lack of adherence to recommended care correlated with increased risks of intubation (relative risk, 2.4) and admission to the intensive care unit (relative risk, 1.65). For patients who did or did not receive recommended acute seizure care, duration of ventilation was commonly <24 hours (87%). Only 32% of events treated initially with a benzodiazepine received a recommended weight-based dosage; underdosing was most common.
"Adherence to evidence-based recommended acute seizure treatment during initial care of pediatric patients using medical air transportation was poor," the authors write. "Intubation was more common when patients did not receive recommended acute seizure care."
Siefkes H, Holsti M, Morita D, Cook L, Bratton S. Seizure Treatment in Children Transported to Tertiary Care: Recommendation Adherence and Outcomes. Pediatrics. 2016;138(6):e20161527-e20161527. doi:10.1542/peds.2016-1527.