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Challenges for Emergency Medical Services in status epilepticus management

  • Marta Amengual-Gual
    Affiliations
    Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States

    Universitat de les Illes Balears, Palma, Spain
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  • Iván Sánchez Fernández
    Affiliations
    Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States

    Department of Child Neurology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
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  • Alejandra Vasquez
    Affiliations
    Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States

    Division of Child and Adolescent Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, United States
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  • Cristina Barcia Aguilar
    Affiliations
    Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States

    Department of Child Neurology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
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  • Justice Clark
    Affiliations
    Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
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  • Tobias Loddenkemper
    Correspondence
    Correspondence: Tobias Loddenkemper, MD, Professor of Neurology, Harvard Medical School, Division of Epilepsy and Clinical Neurophysiology, Fegan 9, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115.
    Affiliations
    Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
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      Untimely treatment in status epilepticus (SE) is independently associated with increased treatment resistance, morbidity, and mortality, but time to treatment is usually longer than suggested by guidelines in clinical practice.
      • Sánchez Fernández I.
      • Abend N.S.
      • Agadi S.
      • et al.
      Time from convulsive status epilepticus onset to anticonvulsant administration in children.
      SE most commonly begins outside the hospital and treatments take longer when seizures start in this setting.
      • Sánchez Fernández I.
      • Gaínza-Lein M.
      • Abend N.S.
      • et al.
      Factors associated with treatment delays in pediatric refractory convulsive status epilepticus.
      Therefore, we explored one of the potential barriers for Emergency Medical Services (EMS) to provide optimized pediatric prehospital treatment in the US: their protocols.

      Key words

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