Evaluation of Adherence to The Neurocritical Care Society Guidelines in Management of Generalized Convulsive Status Epilepticus at The Emergency Department of Suez Canal University Hospital

Background: Trauma is a serious global health problem, it is the fifth leading cause of significant disability and is still the most frequent cause of death in the first four decades of life, accounting for approximately one in 10 deaths worldwide.Methods: This study is cross sectional prospective study was conducted to evaluate assessment of management of patients according to the advanced trauma life support guideline in Emergency Department at Suez Canal University Hospital. All patients (n=103) were subjected to baseline assessment by history, clinical examination and investigations. The patients were followed up and recorded till the full assessment was done and the decision was made and the fate of the patient was recorded.Results: The majority of the studied patient had motor car crash (55.30%), while motor cycle crash was the second mechanism of trauma (21.40%), run over was the third mechanism (14.60%). Airway management was done (95.1%), cervical spine kept immobilized only in (71.8%). Blood pressure was measured in (97.1%) and 2ry survey assessment, head to toe examination (78.6%), while AMPLE history was taken in minority of cases percentage (33%). Finally majority of patients was admitted in ICU (44.70%), followed by 18.40% of the studied patient died and less than (2%) discharged from the ER.Conclusions: ATLS protocols provide a common framework and organized approach during polytrauma patient’s management. Also, it has been shown to improve outcomes so we should enhance its application in our hospital.

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Convulsive Status Epilepticus in a Cohort of Patients from a Peruvian Academic Hospital

Journal of Epilepsy Research ◽

10.14581/jer.21011 ◽

2021 ◽

Vol 11 (1) ◽

pp. 83-92

Author(s):

Marcelo Bedoya-Sommerkamp ◽

Victor Hugo Chau-Rodríguez ◽

Jesús Medina-Ranilla ◽

Alejandro Escalaya-Advíncula ◽

Ray Ticse-Aguirre ◽

...

Keyword(s):

Emergency Department ◽

Developing Countries ◽

Status Epilepticus ◽

Convulsive Status Epilepticus ◽

Academic Hospital ◽

Post Discharge ◽

Hospital Arrival ◽

Line Therapy ◽

Neurologic Emergency

Background and Purpose: Status epilepticus is a neurologic emergency whose epidemiology, etiology and management are scarcely known in developing countries. Our objective was to describe the demographic and clinical features as well as the management of generalized convulsive status epilepticus (GCSE) in adult patients admitted to the emergency department of an academic hospital in Peru, between March 2019 and March 2020.Methods: Observational study of a prospective cohort in which patients were assessed by the emergency and neurology department on the first day of hospitalization, at discharge and at 30 days post-discharge in a follow-up visit. Relevant demographics and clinical data were collected. After being encoded and sorted, univariate statistical analysis was carried out.Results: Of the sample of 59 patients, 62.7% were males, 57.6% were unemployed, 89.8% did not finish high school, and 55.9% had intermittent GCSE with no seizure at arrival. The total calculated median times were: 60 minutes from GCSE onset to hospital arrival, 110 minutes from GCSE onset to 1st line therapy, and 7 minutes from hospital arrival to 1st line therapy. The most frequently used antiepileptic drugs were one dose of benzodiazepine (41.7%), phenytoin (76.9%), and additional doses of benzodiazepines (60%) for 1st, 2nd, and 3rd line therapies, respectively. The most frequent etiologies were antiepileptic drug suspension (27.1%), undetermined (25.4%) and acute stroke (11.8%). 62.71% had 0-2 modified Rankin score at discharge.Conclusions: In this cohort of patients, GCSE was mainly intermittent. Management times differed from the guidelines’ recommendations.

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