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Variation in Prehospital Protocols for Pediatric Seizure Within the United States

Sriram Ramgopal1, Kerry McCans2, Christian Martin-Gill3

  • 1From the Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Chicago, IL.

Pediatric Emergency Care
|February 4, 2020
PubMed

Insights

Statewide prehospital protocols for pediatric seizures vary widely in medication choices and dosing. Further research is needed to optimize emergency medical services (EMS) management of pediatric seizures, including blood glucose monitoring and medication administration routes.

Area of Science:

  • Emergency medicine
  • Pediatric neurology
  • Public health policy

Background:

  • Prehospital management of pediatric seizures is critical for patient outcomes.
  • Standardized protocols are essential for consistent emergency medical services (EMS) care.
  • Existing statewide protocols for pediatric seizure management exhibit significant variation.

Purpose of the Study:

  • To compare statewide prehospital protocols for pediatric seizure management across the United States.
  • To identify variations in antiepileptic drug (AED) selection, administration routes, and dosing.
  • To analyze differences in the management of febrile seizures within these protocols.

Main Methods:

  • Descriptive analysis of statewide EMS protocols for pediatric seizure management in the US.
  • Inclusion criteria: availability of statewide protocol or model.
  • Comparison of AEDs, routes, dosages, and febrile seizure management strategies.

Main Results:

  • 34 of 50 states had usable protocols, all addressing pediatric seizures.
  • Significant variability observed in AED recommendations, administration routes (intramuscular, intranasal), and dosing.
  • Protocols often included blood glucose measurement (94%) and some addressed febrile seizures (62%).

Conclusions:

  • While statewide protocols exist, substantial variability in pediatric seizure management necessitates standardization.
  • Areas for improvement include AED dose optimization, prioritizing blood glucose checks, and enhancing intranasal/intramuscular medication guidance.
  • Further research should focus on optimizing prehospital pediatric seizure care through evidence-based protocol refinement.
Abstract

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