Intramuscular midazolam versus intravenous lorazepam in the pre-hospital treatment of status epilepticus (the RAMPART trial) Project Summary
نویسندگان
چکیده
Target disease: Status Epilepticus (SE). Status epilepticus is a true neurologic emergency associated with significant morbidity and mortality. It has been estimated that there are between 120,000 and 200,000 cases of status epilepticus in this country each year resulting in as many as 55,000 deaths. 1 An incidence of between 6.2 and 18.3 per 100,000 persons has been reported in the United States. Complications of prolonged seizures include impaired ventilation and subsequent pulmonary aspiration, cardiac dysrhythmias, derangements of metabolic and autonomic function, and direct injury to the nervous system. 2
منابع مشابه
RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial): a double-blind randomized clinical trial of the efficacy of intramuscular midazolam versus intravenous lorazepam in the prehospital treatment of status epilepticus by paramedics.
Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting has been shown to be associated with improved outcomes. However, an increasing number of Emergency Medical System (EMS) protocols use an intramuscular (IM) route because it is faster and consistently achievable. RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial) ...
متن کاملPre-hospital midazolam for benzodiazepine-treated seizures before and after the Rapid Anticonvulsant Medication Prior to Arrival Trial: A national observational cohort study
BACKGROUND Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding i...
متن کاملIntramuscular versus intravenous benzodiazepines for prehospital treatment of status epilepticus.
Acute seizures account for 1% of adult and 2% of pediatric emergency department visits, at an annual cost of $1 billion (in U.S. dollars).1 When seizures are prolonged or repetitive without recovery between episodes, the condition is termed status epilepticus, and it occurs in approximately 6% of visits to the emergency department for seizures. The cost for inpatient care of patients in status ...
متن کاملIntramuscular versus intravenous therapy for prehospital status epilepticus.
BACKGROUND Early termination of prolonged seizures with intravenous administration of benzodiazepines improves outcomes. For faster and more reliable administration, paramedics increasingly use an intramuscular route. METHODS This double-blind, randomized, noninferiority trial compared the efficacy of intramuscular midazolam with that of intravenous lorazepam for children and adults in status...
متن کاملEvidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society.
CONTEXT The optimal pharmacologic treatment for early convulsive status epilepticus is unclear. OBJECTIVE To analyze efficacy, tolerability and safety data for anticonvulsant treatment of children and adults with convulsive status epilepticus and use this analysis to develop an evidence-based treatment algorithm. DATA SOURCES Structured literature review using MEDLINE, Embase, Current Conte...
متن کامل