Abstract Details

Title Seizure Alert: An Interdisciplinary Protocol for Timely Anti-Seizure Medication Administration in the Setting of Status Epilepticus

Topic Practice, Policy, and Ethics

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 1-004

Background

Status epilepticus (SE) is an emergency associated with high morbidity and mortality. Between 50,000 and 150,000 Americans each year have SE, with mortality after the first episode estimated at 16-20%. Data has shown that delays in time to administration of first and subsequently second line agents significantly increased morbidity, mortality, and length of stay of hospitalized patients.

Objective Through a quality improvement project, our team sought to implement an interdepartmental seizure alert protocol, where medication and resources can be deployed to ensure timely ASM administration.

Design/Methods

Healthcare providers may activate a seizure alert by calling the operator, who then pages the neurology resident and pharmacy, with a message reading “code seizure” including the patient’s location. Responders can work collaboratively at bedside to coordinate administration of first and second line ASM if warranted. Pharmacy will have a pre-packaged kit of second line ASMs that can be rapidly deployed to the patient location. The physician and pharmacist at bedside can work together to determine the appropriate ASM. Educational sessions for nursing and pharmacy were held prior to implementation of the protocol.

Results In seizures which presented as stroke mimics (pre-intervention data) where a stroke alert was activated (n=39), time of stroke alert activation to the ASM load took an average of 112 minutes. In those patients where seizure alert (post-intervention) was activated (n=9), time to second-line ASM load from alert activation took an average of 87 minutes. Future analysis will be aimed at group comparisons via histograms and parametric tests with independently paired t-tests.

Conclusions

Our goal was to implement a seizure alert protocol in order to streamline patient care and improve time to second-line ASM administration. We are continuing to collect post-intervention data which may have important implications in the interdisciplinary bedside assessment and treatment of patients with suspected SE.

Authors/Disclosures
Kelly L. Block, DO PRESENTER	Dr. Block has nothing to disclose.
Lauren C. Skalomenos, MD (UT San Antonio)	Dr. Skalomenos has nothing to disclose.
Joanna J. Chang, MD	Dr. Chang has nothing to disclose.
Shaun O. Smart, MD	Dr. Smart has nothing to disclose.