Rectal diazepam solution in the treatment of convulsions in the children's emergency room

Area of Science:

• Pediatric Emergency Medicine
• Clinical Pharmacology

Background:

• Acute seizures in children are a common pediatric emergency.
• Prompt and effective anticonvulsant therapy is crucial in managing pediatric seizures.

Purpose of the Study:

• To evaluate the efficacy and safety of rectal diazepam solution for acute seizures in pediatric patients.
• To compare the response rates based on seizure duration prior to treatment.

Main Methods:

• Prospective administration of rectal diazepam solution to 55 convulsing children.
• Documentation of seizure cessation time and response to subsequent intravenous diazepam if necessary.
• Monitoring for adverse events, specifically respiratory depression.

Main Results:

• Seventy-one percent of children experienced seizure cessation within 5 minutes of rectal diazepam administration.
• An additional 7% responded between 5 and 10 minutes.
• Rectal diazepam was ineffective in 16% of cases, but these patients responded to intravenous diazepam.
• Seizures lasting less than 15 minutes prior to treatment showed a higher response rate (81%) compared to those lasting longer (46%).
• Four children experienced transient respiratory depression.

Conclusions:

• Rectal diazepam solution is an adequate and effective option for controlling most acute seizures in children.
• Its ease of administration by paramedical personnel is a significant advantage in emergency settings.
• While intravenous diazepam may be superior, rectal administration provides a valuable alternative, particularly in pre-hospital or resource-limited environments.