Researching a change into pediatric seizure protocol for EMS providers

The longer a child has a seizure after 5 minutes, the harder it is to stop with medications. This fact is why developing protocols and eliminating barriers for Emergency Medical services to provide anti-seizure rescue medications quickly is so important. Primary Children’s’ Emergency Department hopes a new clinical trial will further empower EMS pre-hospital providers to treat child seizures in a safe and timely manner.

Jade Elliott spoke with Dr. Maija Holsti, MD, MPH, Professor of Pediatrics at the University of Utah, about this clinical trial.

The Pediatric Dose Optimization for Seizures in EMS (PediDOSE) study created by Primary Children’s Hospital in collaboration with Salt Lake City Fire, West Valley Fire, and Unified Fire EMS will run over a period of 4 years at Primary Children’s Emergency Department and 20 other sites across the country.

Paramedics currently perform multiple calculations to determine the dosing for anti-seizure medications, which has led to under-dosing and delays in treatment of pediatric seizures. About a ⅓ of pediatric patients on average are transported to Emergency Departments still seizing due to these delays and under-dosing.

The study will compare dosing of the anti-seizure medication, midazolam, based on age versus conventional dosing based on weight. Age-based dosing will eliminate steps and simplify the protocols for EMS prehospital providers, supporting paramedics to give the correct dose in a timely manner.

Special rules for emergency research by the FDA allows patients to be enrolled in research without prior consent if there is not time to consent. Because a seizure is an emergency and requires immediate treatment, all eligible patients will be consented after enrollment at Primary Children’s Hospital. We will be studying these patients until they leave the hospital to ensure that it is effective and safe.

To be eligible for enrollment in this study, patients must be:

• Age: 6 months to 13 years old
• Actively having a seizure in the presence of a paramedic EMS provider
• Transported by Salt Lake City Fire, West Valley Fire, and Unified Fire Emergency Medical Services to Primary Children’s Hospital

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