Improving Quality of Care for Status Epilepticus: Putting Protocols into Practice.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY Current Neurology and Neuroscience Reports Pub Date : 2024-09-01 Epub Date: 2024-07-12 DOI:10.1007/s11910-024-01356-9

Susanna S O'Kula, Chloé E Hill

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Abstract

Purpose of review: Timely treatment of status epilepticus (SE) improves outcomes, however gaps between recommended and implemented care are common. This review analyzes obstacles and explores interventions to optimize effective, evidence-based treatment of SE.

Recent findings: Seizure action plans, rescue medications, and noninvasive wearables with seizure detection capabilities can facilitate early intervention for prolonged seizures in the home and school. In the field, standardized EMS protocols, EMS education, and screening tools can address variability in SE definitions and treatment, particularly benzodiazepine dosing. In the emergency room and hospital, provider education, SE order sets and alerts, and rapid EEG technologies, can shorten time to first-line therapy, second-line therapy, and EEG initiation. Widespread, sustained improvement in SE care remains challenging. A multipronged approach including emphasis on pre-hospital intervention, treatment protocols adapted to local contexts, and SE databases to systematically collect process and outcome metrics have the potential to transform SE treatment and outcomes.

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提高癫痫状态护理质量：将规程付诸实践。

审查目的：及时治疗癫痫状态（SE）可改善预后，但建议治疗与实际治疗之间的差距很常见。本综述分析了障碍并探讨了干预措施，以优化有效、循证的癫痫状态治疗：癫痫发作行动计划、抢救药物和具有癫痫发作检测功能的无创可穿戴设备可促进对家庭和学校中长期癫痫发作的早期干预。在现场，标准化的急救协议、急救教育和筛查工具可以解决癫痫发作定义和治疗，尤其是苯二氮卓剂量方面的差异。在急诊室和医院，医疗服务提供者教育、SE 医嘱集和警报以及快速脑电图技术可以缩短一线治疗、二线治疗和脑电图启动的时间。广泛、持续地改善 SE 护理仍具有挑战性。一种多管齐下的方法，包括重视院前干预、根据当地情况调整治疗方案，以及建立 SE 数据库以系统地收集过程和结果指标，都有可能改变 SE 治疗和结果。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.