Recognition and treatment of status epilepticus in the prehospital setting

PurposeWe performed this retrospective data bank analysis to evaluate the management of status epilepticus (SE) in prehospital setting and possible association treatment delay or insufficient approach with outcome.MethodWe evaluated all episodes a SE according our hospital record system between January 1st 2014 December 31st 2018. Classification ILAE classification 2015, Status Epilepticus Severity Score (STESS), Charlson Comorbidity Index (CCI) at admission Modified Rankin Scale (mRS) discharge death were recorded calculated. Statistical was Mann-Withney-U test, Chi-Square test corrections Yates Bonferroni-Holmes where appropriate.ResultsThere 331 282 patients fatality rate 7.6 %. Median age 72 years. Patients who died significantly older had higher STESS CCI than survived. recognised only 56.8 % episodes. recognized younger others. more often recognized, when epilepsy known. Overall 48 another type generalized convulsive diagnosis missed. without SE. discharged from new deficit, not setting. In initiation benzodiazepine (BZD) likely be deficit After excluding cases documentation steps 273 remained. 178 these known before, but 11.2 them rescue medication given by bystanders. 6.7 BZD an appropriate way nearly lorazepam (88.9 %) midazolam (97.8 dosage below recommended level.ConclusionsMissing frequent associated risk developing neurological deficit. Treatment lower underdosed vast majority situations.