A Study on Factors Causing Prehospital Delay in Treatment of Status Epilepticus

To identify factors causing prehospital delay in treatment of status epilepticus (SE).

This is a prospective observational study done on 78 patients with SE in the Stanley Medical College, Chennai, over 2 years. Demographic SE-related data and treatment delay were entered and correlated with outcome.

The delay in reaching tertiary care was more in patients who traveled by own vehicle, compared to emergency medical services (EMS). Only 4 patients (5.1%) received treatment at the onset site and only seven patients (9%) who traveled in EMS received antiepileptic drugs. There is a significant delay in reaching the tertiary center from the onset of seizures if the patient is taken to any health center before coming to tertiary center (132.352 minutes). All the patients who were taken to another health center before reaching the tertiary center had received their initial treatment and favorable outcomes. Patients with prior history of seizures or SE had a better outcome.

Early recognition of SE is necessary to initiate rapid treatment, preferably during the prehospital phase. EMS personnel should be prepared to treat SE promptly with the recommended first-line drugs.