Clinical Guidelines in Acute Seizure Management

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Presentation transcript:

Clinical Guidelines in Acute Seizure Management William C. Dalsey, MD, FACEP, MBA Department of Emergency Medicine Robert Wood Johnson University Hospital New Jersey sparkledmd@aol.com 215-654-1190

How Do You Begin to Create a Clinical Guideline for Seizures? Selecting the Topic Selecting Members of the Committee Process for Evaluating the Literature Process to Create Clinical Guideline

Critical Questions How do you evaluate and treat a patient with a seizure? Complicating Factors: Status Epilepticus? Hypoglycemia, Febrile Seizures, Alcohol Withdrawal, Trauma, Eclampsia

What is best? Efficacy of Treatment? Safety? Complications? Side Effects? Route of Administration? Costs? Society/Ethics?

Are There Existing Practice Guidelines? www.guidelines.gov AMA Clinical Guidelines Clearinghouse Cochrane Library

Asking the “Right” Questions The need to be specific Identification of inclusion/exclusion criteria Searching the Literature Metanalysis and Nonrandomized Trials