National Guideline Clearinghouse | Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures.

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National Guideline Clearinghouse | Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures.



American College of Emergency Physicians

Guideline Title

Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures.

Bibliographic Source(s)

Huff JS, Melnick ER, Tomaszewski CA, Thiessen ME, Jagoda AS, Fesmire FM, American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2014 Apr;63(4):437-447.e15. [55 references] PubMed

Guideline Status

This is the current release of the guideline.

This guideline updates a previous version: Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2004 May;43(5):605-25. [95 references]

Ann Emerg Med. 2014 Apr;63(4):437-47.e15. doi: 10.1016/j.annemergmed.2014.01.018.

Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures.

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Seizures, Huff JS, Melnick ER, Tomaszewski CA,Thiessen ME, Jagoda AS, Fesmire FM.

Abstract

This clinical policy from the American College of Emergency Physicians is the revision of a 2004 policy on critical issues in the evaluation and management of adult patients with seizures in the emergency department. A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) In patients with a first generalized convulsive seizure who have returned to their baseline clinical status, should antiepileptic therapy be initiated in the emergency department to prevent additional seizures? (2) In patients with a first unprovoked seizure who have returned to their baseline clinical status in the emergency department, should the patient be admitted to the hospital to prevent adverse events? (3) In patients with a known seizure disorder in which resuming their antiepileptic medication in the emergency department is deemed appropriate, does the route of administration impact recurrence of seizures? (4) In emergency department patients with generalized convulsive status epilepticus who continue to have seizures despite receiving optimal dosing of a benzodiazepine, which agent or agents should be administered next to terminate seizures? A literature search was performed, the evidence was graded, and recommendations were given based on the strength of the available data in the medical literature.

PMID:

 

24655445

 

[PubMed - indexed for MEDLINE]