BACKGROUND: Status epilepticus (SE) is a neurologic emergency with high morbidity and mortality. Delays in SE treatment are common in clinical practice and can be associated with poorer outcomes. Our goal was to determine whether the implementation of an SE alert protocol improves time to administration of a second-line antiseizure medication (ASM) in hospitalized adults. METHODS: We developed and implemented an inpatient SE alert system. A quasiexperimental cohort study was performed. We analyzed all patients aged 18-85 years who were managed at the University of Kentucky Medical Center using the SE alert protocol between March 2015 and June 2017 (n = 19). Controls were the first 20 consecutive patients treated for SE over the same time period, but who were managed with usual care (i.e., without SE alert protocol). RESULTS: Time to administration of a second-line ASM was shorter with the use of the SE alert system (22.21 ± 3.44 minutes) compared to usual care (58.30 ± 6.72 minutes; p < 0.0001). CONCLUSION: Implementation of an SE alert system led to a marked improvement in time to administration of a second-line ASM. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for adult inpatients treated for SE, implementation of an SE alert protocol reduces time to administration of second-line ASM.
BACKGROUND: Status epilepticus (SE) is a neurologic emergency with high morbidity and mortality. Delays in SE treatment are common in clinical practice and can be associated with poorer outcomes. Our goal was to determine whether the implementation of an SE alert protocol improves time to administration of a second-line antiseizure medication (ASM) in hospitalized adults. METHODS: We developed and implemented an inpatient SE alert system. A quasiexperimental cohort study was performed. We analyzed all patients aged 18-85 years who were managed at the University of Kentucky Medical Center using the SE alert protocol between March 2015 and June 2017 (n = 19). Controls were the first 20 consecutive patients treated for SE over the same time period, but who were managed with usual care (i.e., without SE alert protocol). RESULTS: Time to administration of a second-line ASM was shorter with the use of the SE alert system (22.21 ± 3.44 minutes) compared to usual care (58.30 ± 6.72 minutes; p < 0.0001). CONCLUSION: Implementation of an SE alert system led to a marked improvement in time to administration of a second-line ASM. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for adult inpatients treated for SE, implementation of an SE alert protocol reduces time to administration of second-line ASM.
Authors: Tracy Glauser; Shlomo Shinnar; David Gloss; Brian Alldredge; Ravindra Arya; Jacquelyn Bainbridge; Mary Bare; Thomas Bleck; W Edwin Dodson; Lisa Garrity; Andy Jagoda; Daniel Lowenstein; John Pellock; James Riviello; Edward Sloan; David M Treiman Journal: Epilepsy Curr Date: 2016 Jan-Feb Impact factor: 7.500
Authors: Dominik Madžar; Anna Geyer; Ruben U Knappe; Stephanie Gollwitzer; Joji B Kuramatsu; Stefan T Gerner; Hajo M Hamer; Hagen B Huttner Journal: J Neurol Date: 2016-01-02 Impact factor: 4.849
Authors: Iván Sánchez Fernández; Nicholas S Abend; Satish Agadi; Sookee An; Ravindra Arya; James Nicholas Brenton; Jessica L Carpenter; Kevin E Chapman; William D Gaillard; Tracy A Glauser; Howard P Goodkin; Kush Kapur; Mohamad A Mikati; Katrina Peariso; Margie Ream; James Riviello; Robert C Tasker; Tobias Loddenkemper Journal: Neurology Date: 2015-05-06 Impact factor: 9.910
Authors: E Santamarina; M Gonzalez; M Toledo; M Sueiras; L Guzman; N Rodríguez; M Quintana; G Mazuela; X Salas-Puig Journal: Epilepsy Behav Date: 2015-06-25 Impact factor: 2.937
Authors: Eugen Trinka; Hannah Cock; Dale Hesdorffer; Andrea O Rossetti; Ingrid E Scheffer; Shlomo Shinnar; Simon Shorvon; Daniel H Lowenstein Journal: Epilepsia Date: 2015-09-04 Impact factor: 5.864
Authors: Greg Ogrinc; Louise Davies; Daisy Goodman; Paul Batalden; Frank Davidoff; David Stevens Journal: BMJ Qual Saf Date: 2015-09-14 Impact factor: 7.035