What Should We Prescribe for Acute Seizures When There is No Intravenous Access?

Szaflarski, Jerzy P.

doi:10.5698/1535-7511-16.3.135

Cited by 1 publication

(3 citation statements)

References 10 publications

(12 reference statements)

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“…common typically include somnolence, dysgeusia, headache, nasal discomfort, nasopharyngitis, diarrhea; Detyniecki et al, 2019;Hogan et al, 2020;Neurelis, Inc., 2021;UCB, Inc., 2021), which contrasts with the risks of not administering rescue medications, which may include prolonged seizures and status epilepticus, which increases the risk of irreversible neurologic injury and death (Sheppard & Lippé, 2012;Szaflarski, 2016).…”

Section: When To Use Rescue Medicationsmentioning

confidence: 99%

“…A recent patient survey suggested that approximately 37% of patients who received intranasal diazepam administered at the first sign of a seizure felt like their usual selves within 30 minutes, and approximately 60% felt like their usual selves after 1 hour (Penovich et al, 2021). In clinical trials, benzodiazepines have demonstrated effectiveness with generally mild side effects (most common typically include somnolence, dysgeusia, headache, nasal discomfort, nasopharyngitis, diarrhea; Detyniecki et al, 2019; Hogan et al, 2020; Neurelis, Inc., 2021; UCB, Inc., 2021), which contrasts with the risks of not administering rescue medications, which may include prolonged seizures and status epilepticus, which increases the risk of irreversible neurologic injury and death (Sheppard & Lippé, 2012; Szaflarski, 2016).…”

Section: When To Use Rescue Medicationsmentioning

confidence: 99%

“…Safety of medication administration is one of the most important aspects of seizure management, and the National Association of School Nurses (NASN; 2017) guidelines emphasize that medication administration policies and procedures should focus on safety. Although it is important to be vigilant regarding dosing errors, safe medication administration, and side effects of benzodiazepines, it is also important to recognize the risks to the student associated with having a seizure (Szaflarski, 2016). Thus, utilizing rescue therapy is an important component of seizure management in schools.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Managing Acute Seizures: New Rescue Delivery Option and Resources to Assist School Nurses

et al. 2021

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Approximately 470,000 children and adolescents in the United States have epilepsy, 30% of whom experience seizures despite antiseizure drug regimens. School nurses, teachers, caregivers, and parents play integral roles in implementing a care plan that avoids triggers, recognizes signs, and provides supportive care—ideally, guided by a patient-specific seizure action plan, which may include the use of rescue medication. Benzodiazepines are the mainstay of seizure rescue medication; for decades, rectally administered diazepam was the only approved rescue medication for seizure clusters outside the hospital setting. However, rectal administration has limitations that could delay treatment (e.g., social acceptability, removal of clothing, positioning). More recently, intranasal midazolam (for patients ≥12 years) and intranasal diazepam (for patients ≥6 years) were approved for this indication. Training and education regarding newer forms of rescue medication should improve confidence in the ability to treat seizures in school with the goal of increasing the safety of students with epilepsy.

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