Prehospital seizure management protocols need standardized guidelines. A descriptive study from Norway

Area of Science:

• Neurology
• Emergency Medicine
• Clinical Practice Guidelines

Background:

• Convulsive seizures are a common neurological emergency.
• Current prehospital seizure management lacks standardized European guidelines.
• Most patients are hospitalized for seizure treatment, with inconsistent prehospital interventions.

Purpose of the Study:

• To analyze prehospital seizure control protocols in Norwegian Emergency Medical Services (EMS).
• To compare current Norwegian EMS protocols with evidence-based acute seizure management.
• To identify variations and inconsistencies in prehospital seizure treatment.

Main Methods:

• Descriptive analysis of 18 regional Norwegian EMS protocols.
• Comparison of protocol findings with recent evidence on prehospital treatment.
• Evaluation of recommended drugs, dosages, administration routes, and treatment definitions.

Main Results:

• Significant variations exist in preferred medications, dosages, and administration methods.
• Only 33% of protocols explicitly define status epilepticus per guidelines.
• Few protocols (16.7%) define benzodiazepine administration criteria; only 28% state clear first-line treatment.

Conclusions:

• Disparities in prehospital seizure management protocols are evident in Norway.
• The Norwegian system's variations are comparable to other European countries.
• Standardized prehospital treatment guidelines are essential for improved seizure management.