Related Experiment Video

Updated: Oct 14, 2025

Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
09:57

Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization

Published on: September 20, 2024

2.9K

Optimized Benzodiazepine Treatment of Pediatric Status Epilepticus Through a Standardized Emergency Medical Services

Jennifer C Keene1, Brandon Woods2, Mark Wainwright1

  • 1Seattle Children's Hospital, Seattle, Washington; Division of Child Neurology, Department of Neurology, University of Washington, Seattle, Washington.

Pediatric Neurology
|November 4, 2021
PubMed

Insights

Emergency Medical Services (EMS) training with Medic One Pediatric (MOPed) cards significantly improved benzodiazepine (BZD) dosing for pediatric status epilepticus (SE). However, further optimization is needed for second-line treatments to improve patient outcomes.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurology
  • Clinical Interventions

Background:

  • Optimized benzodiazepine (BZD) dosing is crucial for reducing morbidity and mortality in pediatric status epilepticus (SE).
  • Previous interventions for SE have primarily focused on in-hospital treatment, despite over 75% of pediatric SE cases initially being managed by emergency medical services (EMS).
  • Widespread underdosing of BZDs in pediatric SE has been documented in prior studies.

Purpose of the Study:

  • To assess the impact of an EMS-focused, collaboratively developed dosing aid (Medic One Pediatric [MOPed] cards) and training on BZD dosing in pediatric SE.
  • To evaluate the effect of the MOPed intervention on key pediatric SE outcomes.

Main Methods:

  • A retrospective review was conducted on pediatric patients (≤12 years) treated by EMS for SE and transferred to Seattle Children's Hospital.
  • Data were collected for the year preceding and the period immediately following MOPed card training implementation.
  • Primary outcome: percentage of patients receiving underdosed BZD treatment. Secondary outcomes: time to second-line antiseizure medication (ASM), intubation, and intensive care unit (ICU) admission.

Main Results:

  • The percentage of children receiving underdosed BZDs significantly decreased from 52% to 6% post-MOPed implementation (P < 0.001).
  • Patient demographics (age, gender, pre-existing epilepsy) were similar between the pre- and post-intervention groups.
  • No significant reduction was observed in the rates of intubation or ICU admission, and the interval to second-line ASM treatment remained prolonged.

Conclusions:

  • EMS-focused training using MOPed cards significantly improved the administration of recommended initial BZD treatment for pediatric SE.
  • The intervention did not significantly alter intubation or ICU admission rates, indicating a need for further improvements in out-of-hospital SE management.
  • Enhanced access to and timely use of second-line antiseizure medications are critical for optimizing out-of-hospital pediatric SE care.
Abstract

Keywords:
BenzodiazepineEmergency medical servicesQuality improvementStatus epilepticus

More Related Videos

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

20.0K
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model04:55

Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model

Published on: May 26, 2023

966

Related Concept Videos

Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
432
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
113
Drug Delivery: Enteral Route01:18

Drug Delivery: Enteral Route

The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
852
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
123
Anxiolytic Drugs: Benzodiazepines and Buspirone01:29

Anxiolytic Drugs: Benzodiazepines and Buspirone

Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
1.5K
Cardiopulmonary Resuscitation I: Adult01:21

Cardiopulmonary Resuscitation I: Adult

Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
168