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Adapting Evidence-Based Practice Guidelines for Emergency Management of Seizures in Children Beyond the Neonatal
Ashraf Abdel Baky1, Ashraf Al Refaei2, Ebtesam El Melegy3
1Pediatrics Department, Ain Shams University, Cairo, Egypt; Pediatrics Department, Armed Forces College of Medicine (AFCM), Cairo, Egypt.
Insights
This study adapted international guidelines for childhood seizure emergencies in Egypt, creating a national clinical practice guideline (CPG) for standardized, accessible treatment. The goal is to improve immediate seizure control for children nationwide.
Area of Science:
- Pediatric Neurology
- Clinical Practice Guidelines
Background:
- International recommendations for emergency seizure management in children were adapted for the Egyptian healthcare context.
- An evidence-based clinical practice guideline (CPG) was developed to standardize treatment for acute epileptic seizures.
Purpose of the Study:
- To standardize the treatment of acute epileptic seizures in children beyond the neonatal period in Egypt.
- To provide an accessible, easy-to-apply acute treatment protocol for immediate seizure control.
Main Methods:
- Adaptation of the international "Adapted ADAPTE" methodology by the Egyptian Pediatric Clinical Practice Guidelines Committee (EPG).
- Collaboration with 15 Egyptian university pediatric departments and the National Research Centre.
- Review and adaptation of recommendations from three international source CPGs.
Main Results:
- Development of a National CPG for the emergency management of childhood seizures.
- Inclusion of eight implementation tools and multifaceted strategies for clinicians, patients, and nurses.
- Contextualization of recommendations for national settings in Egypt.
Conclusions:
- The adaptation methodology offers valuable insights for national CPG implementation in Egypt.
- Successful adaptation of international guidelines to a national context for improved pediatric care.
Background:
The presented evidence-based clinical practice guideline (CPG) is proposed as a National CPG where we adapted the international recommendations for the emergency management of seizures in children beyond the neonatal period to suit the health care in Egypt. The quality of evidence and the strength of recommendations are indicated. This study aimed to standardize the treatment of acute epileptic seizures and to provide an easy-to-apply acute treatment protocol that will allow immediate and appropriate seizure control.
Methods:
This is part of a larger program by the Egyptian Pediatric Clinical Practice Guidelines Committee (EPG) in collaboration with the staff of pediatric departments of 15 Egyptian universities and the National Research Centre. EPG was affiliated later to the Supreme Council of the Egyptian University Hospitals aiming to define the topics of, assign authors to, and assist in the adaptation of pediatric evidence-based CPGs according to a national strategic plan (http://epg.edu.eg). The committee is guided by a formal CPG adaptation methodology: the "Adapted ADAPTE."
Results:
The Egyptian Childhood Seizure Group (ECSG) reviewed the results of the Appraisal of Guidelines for Research and Evaluation II assessment and decided to adapt the recommendations of three source CPGs: American Epilepsy Society, Italian League Against Epilepsy, Neurocritical Care Society, and Neurologic & Psychiatric Society of Zambia. Eight implementation tools were included. A comprehensive set of multifaceted CPG implementation strategies was provided for the clinicians, patients, nurses, and other relevant stakeholders contextualized to the national settings.
Conclusions:
Our experience with this adaptation methodology provides useful insight into its national utilization in Egypt.
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