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Statewide Emergency Medical Services Protocols for Status Epilepticus Management
Author(s) -
Han Ethan J.,
Chuck Carlin C.,
Martin Thomas J.,
Madsen Tracy E.,
Claassen Jan,
Reznik Michael E.
Publication year - 2021
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.25989
Subject(s) - lorazepam , midazolam , status epilepticus , medicine , diazepam , benzodiazepine , emergency medical services , dose , anesthesia , emergency medicine , epilepsy , psychiatry , pharmacology , sedation , receptor
Although seizures are common in prehospital settings, standardized emergency medical services (EMS) treatment algorithms do not exist nationally. We examined nationwide variability in status epilepticus treatment by analyzing 33 publicly available statewide EMS protocols. All adult protocols recommend intravenous benzodiazepines (midazolam, n = 33; lorazepam, n = 23; diazepam, n = 24), 30 recommend intramuscular benzodiazepines (midazolam, n = 30; lorazepam, n = 8; diazepam, n = 3), and 27 recommend intranasal benzodiazepines (midazolam, n = 27; lorazepam, n = 3); pediatric protocols also frequently recommend rectal diazepam (n = 14). Recommended dosages vary widely, and first‐ and second‐line agents are designated in only 18 and 2 states, respectively. Given this degree of variability, standardized national EMS guidelines are needed. ANN NEUROL 2021;89:604–609