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Diazepam and intubation in emergency treatment of seizures in children
R A Orr1, R J Dimand, S T Venkataraman
1Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15213.
Study Objectives:
This study was undertaken to determine the incidence of endotracheal intubation after the use of diazepam compared with phenobarbital or phenytoin in emergency treatment of seizures in children.
Design:
The records of all children (98) were reviewed in a case-control fashion. A logistic regression model was used to determine whether there was an association between diazepam administration and intubation, adjusting for all other covariates (age, weight, convulsion time before first anticonvulsant was given, response latency, diagnosis, and therapy).
Setting:
All children were treated in an emergency department and then transported to a tertiary pediatric center by a pediatric transport team.
Type Of Participants:
All patients were children, with a median age of 2.7 years (range 0.17 to 15.3 years).
Interventions:
None.
Measurements And Main Results:
Only the use of diazepam was found to be significantly associated with intubation after adjusting for all other covariates (adjusted odds ratio, 49.4; P less than .001). In the comparison of diazepam versus phenobarbital or phenytoin used as the first anticonvulsant, median response latency did not differ (27.0 vs 32.5 minutes, P greater than .83).
Conclusion:
A significant association was found between diazepam use and intubation. Response latency was not shorter when diazepam was used as the initial anticonvulsant compared with phenobarbital or phenytoin.