naa a22 4500 510799388 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-013-9862-x doi (NATIONALLICENCE)springer-10.1007/s12028-013-9862-x Analysis of the Delay Components in the Treatment of Status Epilepticus [Elektronische Daten] [Leena Kämppi, Harri Mustonen, Seppo Soinila] Background: The factors comprising the delays in management of status epilepticus (SE) have not been systematically studied. Methods: We studied retrospectively all adult patients (N=82) diagnosed with SE in Helsinki University Central Hospital emergency room over a 2-year period. We analyzed prehospital, diagnostic, treatment, and treatment response delays based on medical records and quantitatively evaluated data availability and accuracy. Results: SE manifested mostly without any warning symptoms, but every fifth case presented a pre-status period. Median prehospital delay was 2h 4min, including delays in emergency call, ambulance arrival, and patient transportation. Median delay of diagnosing SE was 2h 10min. EEG-based diagnosis was significantly delayed compared to clinical diagnosis. Median delay in recording EEG was 22h 2min. Median delay of the first medication was 35min, and those of second- and third-stage medications were 3h and 2h 55min, respectively. We applied stepwise definition for treatment response and counted delays accordingly: total convulsion period 5h 52min, Burst-suppression (BS) 17h 30min and return of consciousness 47h 40min. Median treatment period in intensive care unit was 2.7days. Mortality over treatment period (median 7.7days) was 8.5%. No post-discharge follow-up was performed. Conclusion: Our study reveals unexpectedly and unacceptably long delays in SE management, stressing the importance of commitment to acknowledged management protocol. Delays in the treatment can and need to be shortened markedly by several strategies discussed in this article. Springer Science+Business Media New York, 2013 Convulsion nationallicence Seizure nationallicence Epilepsy nationallicence Prehospital nationallicence Kämppi Leena Department of Neurology, University of Helsinki, Helsinki, Finland aut Mustonen Harri Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland aut Soinila Seppo Department of Neurology, University of Turku, Turku, Finland aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 10-18 1541-6933 19:1<10 2013 19 12028 https://doi.org/10.1007/s12028-013-9862-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9862-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kämppi Leena Department of Neurology, University of Helsinki, Helsinki, Finland aut NATIONALLICENCE 700 1- Mustonen Harri Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland aut NATIONALLICENCE 700 1- Soinila Seppo Department of Neurology, University of Turku, Turku, Finland aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 10-18 1541-6933 19:1<10 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer